Introduction Systemic lupus erythematosus is a connective tissue disorder, which causes complex multi organ involvement. Neurological and cardiac manifestations have been well noted but complications such as status epilepticus and acute myocarditis with heart failure at presentation remains uncommon. Case description A 15-year-old, previously healthy, South Asian, Sri Lankan female presented with status epilepticus and the seizures only responded to intravenous midazolam and thiopentone sodium. On the fourth day, she developed tachycardia and shortness of breath and was found to have cardiomyopathy with heart failure with an ejection fraction 40%. Along with a positive urinary sediment, a positive ANA with a very high level of ds-DNA and low C3 and C4 levels confirmed our suspicion of systemic lupus erythematosus. Discussion and evaluation Systemic lupus erythematosus presents in a variety of clinical presentations and the spectrum may range from unique to ubiquitous. Clinicians should have a high index of suspicion specially when encountering atypical presentations with multi-organ involvement, especially when patients tend to be young females. Status epilepticus and myocarditis are uncommon manifestations of systemic lupus erythematosus, and should be appreciated early, as if inappropriately managed would have a deleterious impact on mortality and morbidity.

中文翻译：

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系统性红斑狼疮伴癫痫持续状态和急性心肌病伴急性心力衰竭：病例报告

简介 系统性红斑狼疮是一种结缔组织疾病，会导致复杂的多器官受累。神经和心脏表现已被广泛关注，但癫痫持续状态和急性心肌炎伴心力衰竭等并发症仍然不常见。病例描述 一名 15 岁、既往健康、南亚、斯里兰卡女性出现癫痫持续状态，癫痫发作仅对静脉注射咪达唑仑和硫喷妥钠有反应。第四天，她出现心动过速和呼吸急促，并被发现患有心肌病并伴有射血分数 40% 的心力衰竭。除了阳性尿沉渣外，具有非常高水平的 ds-DNA 和低 C3 和 C4 水平的阳性 ANA 证实了我们对系统性红斑狼疮的怀疑。讨论和评估 系统性红斑狼疮有多种临床表现，范围从独特到普遍存在。临床医生应高度怀疑，尤其是在遇到多器官受累的非典型表现时，尤其是当患者往往是年轻女性时。癫痫持续状态和心肌炎是系统性红斑狼疮的不常见表现，应及早发现，好像处理不当会对死亡率和发病率产生有害影响。