A 28-year-old woman presents with fatigue, weight loss, photosensitivity, and joint pain. She reports a previous episode of pleuritic chest pain and oral ulcers. Examination reveals a malar rash, mild peripheral oedema, and tenderness in multiple small joints. Laboratory investigations show proteinuria (2.5g/day), haematuria, low complement levels, and strongly positive Anti-nuclear antibodies and anti-dsDNA antibodies.
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