Background Cases of uterine wall thinning and placental abnormalities complicated with systemic lupus erythematosus (SLE) during pregnancy have been reported in Asian countries for ten years. Long-term steroid use can cause muscle degeneration, but the mechanism of myometrium thinning was not known. Through the review of published articles, this report is the first review of cases to discuss the pathogenesis and clinical features of thinned myometrium and placenta accreta spectrum (PAS) in pregnant patients with SLE. Case presentation A twenty-nine-year-old primigravida with a history of lupus enteritis and paralytic ileus had a natural conception after less than two years of steroid treatment. An ultrasonographic study showed a thin uterine wall with a widespread thick placenta on the entire surface of the uterine cavity in the third trimester. At the 39th gestational week, she underwent a cesarean section due to the failure of the uterus to contract, even though the injection of oxytocin. There were several engorged vessels on the surface of the anterior uterine wall at the time of laparotomy. We decided to perform a hysterectomy because diffuse PAS replaced her uterus. Conclusion A review of reported cases and our case shows an unusual complication of SLE that might be related to the particular condition of the estrogen-mediated immune system. Clinicians should always pay attention to the possibility of uterine wall thinning as uterine atony and the structural abnormality of the placenta for SLE patients with the unscarred uterus.

Transition-metal complexes Mn(acac) 2 , Mn(bpy) 3 , Fe(acac) 2 , and Fe(bpy) 3 were investigated as mediators in lignin oxidation with an electrolytic mediator system (EMS). Fe(bpy) 3 was screened among them as a mediator in the bulk electrolysis of a lignin dimer model compound (4-ethoxy-3-methoxyphenylglycerol-β-guaiacyl ether: 3G) and guaiacyl-type dehydrogenation polymer (G-DHP) by experiments using the lignin monomer model compound 1-(4-ethoxy-3-methoxyphenyl)ethanol. In Fe(bpy) 3 -mediated electro-oxidations of compound 3G, both Cα−Cβ cleavage and Cα-carbonylation proceeded efficiently in 0.1 M LiClO 4 /70%-CH 3 CN/H 2 O, whereas Cαcarbonylation predominated in 10%-dioxane/0.1 M acetate buffer (pH 4). Fe(bpy) 3 -mediated electro-oxidation of G-DHP also proceeded efficiently via both Cα−Cβ cleavage and Cα-carbonylation in 0.1 M LiClO 4 /70%-CH 3 CN/ H 2 O. The oxidation was promoted by the addition of 2,6-lutidine as a base. By contrast, the Fe(bpy) 3 -mediated electro-oxidations of G-DHP did not proceed efficiently in 10%-dioxane/0.1 M acetate buffer (pH 4) with or without 2,6-lutidine under the present conditions. It was reconfirmed that electrolyte was also one of the important factors in lignin oxidation with EMS. Consequently, Fe(bpy) 3 was found to be a promising mediator of lignin EMS for lignin modification and degradation.

No abstract