A 21-year-old female is described who developed severe cerebral lupus 9 months after the onset of her disease. A dramatic change in her CT brain scan from normal to gross cerebral atrophy was observed in the month following onset of her cerebral disease. This patient developed hepatitis during the course of her hospitalization. This is an unusual manifestation of systemic lupus. The patient's serum also contained anti-Sm antibodies. This is a relatively infrequent finding in the serum of lupus patients outside the United States.