Part of the reason one tends to need to build Qt from source is that Calibre now assumes any C components are built using Visual C++ 2008 (which uses msvc10). Many of the binary installs will not make this assumption.
I built myself a Windows development environment some months ago, and quite a few issues came up which resulted in updates to the wiki article. I did it using VMWare to avoid polluting my normal production PC with lots of development tools. Over the next few days I will try setting up a Windows development environment from scratch again and update the instructions with anything that comes up.
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