Systemic lupus erythematosus presenting with status epilepticus and acute cardiomyopathy with acute heart failure:...

Area of Science:

• Rheumatology
• Neurology
• Cardiology

Background:

• Systemic lupus erythematosus (SLE) is a complex connective tissue disorder with multi-organ involvement.
• While neurological and cardiac issues are known SLE manifestations, status epilepticus and acute myocarditis with heart failure at initial presentation are rare.
• This case underscores the diverse and sometimes atypical clinical spectrum of SLE.

Observation:

• A 15-year-old female presented with refractory status epilepticus.
• She subsequently developed tachycardia, shortness of breath, and heart failure with reduced ejection fraction.
• Diagnostic workup revealed positive ANA, high anti-ds-DNA, low C3/C4, and urinary sediment, confirming SLE.

Findings:

• The patient's presentation with both neurological (status epilepticus) and cardiac (myocarditis) complications is atypical for SLE.
• This case underscores the diverse clinical spectrum of SLE, particularly in young females.
• Prompt diagnosis and management are critical due to the potential for severe outcomes.

Implications:

• Clinicians must maintain a high index of suspicion for SLE in young patients presenting with unusual multi-organ involvement.
• Early identification of rare SLE manifestations like status epilepticus and myocarditis is vital.
• Timely and appropriate management can improve prognosis and reduce mortality in SLE patients.