Expert: Cynthia Donlan - 1/15/2009

Question
Hi!  Finally a Lupus expert!  I've had SLE for 8 years now (after birth of my daughter) and have been in remission for 7 years.  I have been experiencing naseau the last week.    I have been getting a rush of naseau every 2-3 days for over a week and experienced vomiting.  I have gotten chills, my heart would race and my muscles were weak.  BUT it would all go away after 2 hrs!  I have an appt. with my doc tomorrow but was hoping to get some research first.  THANKS!

Answer
Dear Dina:

I am not a doctor. I am not a nurse but I care deeply about people and I have Lupus myself.  I try to read and attend workshops as much as I can because I am the Lower Luzerne County representative for the Lupus Foundation of PA and run the local support group.

I am sorry you are not feeling well.  It seems like you are suffering with a wide variety of symptoms.

let me begin by saying that differentiating Lupus from an infection or virus can be difficult because both have common symptoms and yes even some of the blood work results will look similiar.

Active lupus and an infection may share many symptoms. Further, infection can induce a lupus flare or be difficult to distinguish from a lupus flare. A low white blood cell count is suggestive of active lupus (although certain viruses can also give a low white count) while a high count suggests infection.

If the following symptoms are seen in a DIAGNOSED patient of Systemic Lupus then a flare may be developing.  

Remember that lupus is often a disease that repeats itself. Be on the lookout for a return of symptoms that were experienced at the beginning or onset of your disease.

Persistent (continuing) fatigue which is out of proportion to what you consider your normal fatigue
Persistent weakness
Aching all over without any obvious reason
Persistent fever (In order to establish that you have fever, take your temperature every six hours and write down the results.)
Persistent loss of appetite
Involuntary weight loss
Excessive and persistent hair loss
Recurrent (repeated) nose bleeds
Sores on the roof of the mouth which burn when spicy foods are eaten
Unexplained rash anywhere on the body
Persistent hives
Skin ulcers
Recurrent pain in the joints
Swelling of one or several joints
Persistent joint stiffness upon wakening in the morning
Chest pain which increases when breathing in
Unusual shortness of breath
Coughing up blood
Persistent, unusual headache
Persistent nausea and vomiting
Recurrent or persistent pain in the abdomen
Persistent and worsening swelling of the feet and legs
Persistent swelling of the eyelids
Blood in the urine or in the stools

As we discussed before alot of these symptoms can be seen in other disorders, so it is best to have a rheumatologist make the call.


Lupus makes you more susceptible to infection. Take sensible precautions and avoid those family and friends with obvious known infectious diseases, especially chickenpox.

Also being  on any maintenance level of steroids or immunosupressants can also also increase your susceptibility.  

I wish I could give you more explicit answers then this.  Please write me again if you are having any problems.

You are going to be alright.  TRUST ME!  God Bless

All my love and concern

Cynthia