Pregnancy Related Complications in Patients with Systemic Lupus Erythematosus, An Egyptian Experience

Background Systemic Lupus Erythematosus (SLE) has a tendency to occur in women in their reproductive years, causing complications during pregnancy and labour. Conversely, pregnancy can cause flares of disease activity, often necessitating immediate intervention. Aim of study to study pregnancy related complications in patients with SLE. Patients and methods The study included 48 SLE pregnant females. 27 patients with 38 pregnancies, their data viewed retrospectively from medical records, and 21 patients with 21 pregnancies followed up prospectively. The laboratory data included ANA, DNA, APL antibodies and anti Ro/SSA. The disease activity was calculated according to the Systemic Lupus Activity Measure. Ultrasound was performed to confirm gestational age and assess for the presence of any congenital fetal malformations, and then repeated monthly to detect any abnormality including intrauterine growth restriction. At 30 weeks gestation and onwards, assessment of fetal wellbeing including daily fetal kick chart and once weekly non stress test was performed. Doppler blood flow velocimetry was done for those with abnormal fetal heart rate pattern. After labour, the neonate was examined for complications including complete heart block and neonatal lupus. Results Anti dsDNA was found in 95% of the patients, anti Ro/SSA in 6% and anti APL in 30%. 57% of the patients followed up prospectively had active disease in the 1st trimester, 24% in the 2nd and 62% in the 3rd trimester. The most common maternal complication was preeclampsia 33%, followed by spontaneous abortion 20%. Prematurity was the most common fetal complication 37%, followed by intrauterine growth restriction 29%. 2 neonates were born with congenital heart block and 1 with neonatal lupus. Conclusion Pregnancy in SLE patients is associated with a higher risk of obstetric complications affecting both the mother and the fetus. Preeclampsia was the most common complication followed by prematurity. Preeclampsia was significantly associated with third trimester disease activity

Composition, age, and origin of the ~620 Ma Humr Akarim and Humrat Mukbid A-type granites: no evidence for pre-Neoproterozoic basement in the Eastern Desert, Egypt

The Humr Akarim and Humrat Mukbid plutons, in the central Eastern Desert of Egypt, are late Neoproterozoic post-collisional alkaline A-type granites. Humr Akarim and Humrat Mukbid plutonic rocks consist of subsolvus alkali granites and a subordinate roof facies of albite granite, which hosts greisen and Sn–Mo-mineralized quartz veins; textural and field evidence strongly suggest the presence of late magmatic F-rich fluids. The granites are Si-alkali rich, Mg–Ca–Ti poor with high Rb/Sr (20–123), and low K/Rb (27–65). They are enriched in high field strength elements (e.g., Nb, Ta, Zr, Y, U, Th) and heavy rare earth elements (Lan/Ybn = 0.27–0.95) and exhibit significant tetrad effects in REE patterns. These geochemical attributes indicate that granite trace element distribution was controlled by crystal fractionation as well as interaction with fluorine-rich magmatic fluids. U–Pb SHRIMP zircon dating indicates an age of ~630–620 Ma but with abundant evidence that zircons were affected by late corrosive fluids (e.g., discordance, high common Pb). eNd at 620 Ma ranges from +3.4 to +6.8 (mean = +5.0) for Humr Akarim granitic rocks and from +4.8 to +7.5(mean = +5.8) for Humrat Mukbid granitic rocks. Some slightly older zircons (~740 Ma, 703 Ma) may have been inherited from older granites in the region. Our U–Pb zircon data and Nd isotope results indicate a juvenile magma source of Neoproterozoic age like that responsible for forming most other ANS crust and refute previous conclusions that pre-Neoproterozoic continental crust was involved in the generation of the studied granites