Systemic Lúpus Erythematosus (SLE) is an auto-imune disorder, with multiple organ involvement, characterized by vascular and connective tissue inflammation, as well as antinuclear antibodies (ANA). We report a case of a black teenager with a past of arthritis of knees, fever and astenia during the year previous to this admission. She was admitted to the Pediatric Intensive Care Unit (PICU) for bilateral Streptococcus pneumoniae pneumonia complicated by pleural effusion. She also had generalized edema and macroscopic hematúria. She was started on antibiotics, with improvement. The studies were compatible with active SLE, poliserositis, nephrotic proteinúria, lupic nephritis class IV and serious anemia. During the admission, she had symptomatic hypertension with tonic-clonic seizure. She was transferred to Italy, clinically stable, medicated with steroids, anti-hypertensive and anti-convulsant drugs.