Edited by M. Mahmoudi
Published by Humana Press, USA
Pages: 334. Price: £62.99. ISBN 978-1603274425
“He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.”
Sir William Osler
It is more than a century since Clemens von Pirquet coined the term “allergy”. It has been defined as a phenomenon observed in some individuals who develop “hypersensitive reactions” on exposure to environmental substances. Over the past few decades there has been an alarming increase in the morbidity caused by allergic disorders. It is estimated that approximately one quarter of the population of developed countries are afflicted. Not only do these disorders greatly affect the quality of life of these individuals, but in some instances they can also shorten the length of life. It has been postulated that allergic disorders will emerge as the epidemic of the 21st century.
M. Mahmoudi must be complimented for persuading a galaxy of more than 30 experts, internationally recognised in their field, to present difficult cases in allergy and immunology. The design adopted is unusual but from the point of a practising allergologist, is very useful. The editor has structured most chapters with two illustrative cases but, in some, multiple cases are presented. This is followed by an analysis of diagnosis and discussion. The message is reinforced with pertinent multiple choice questions. Each chapter is backed by “reader friendly” tables and is extensively illustrated. This small but comprehensive volume includes almost all allergic diseases along with immune-mediated disorders.
The book commences with rhinitis, one of the most common allergic disorders. The author discusses a patient with a garden variety of allergic rhinitis, which is also a complex case due to sarcoidosis. Similarly, the chapter on rhinosinusitis describes a usual patient of rhinosinusitis with polyposis and is followed by a case due to Wegener's granulomatosis. The chapter on ocular allergy is well written and beautifully illustrated.
The dermatological allergies comprise three chapters on urticaria and angioedema, allergic contact dermatitis, and atopic dermatitis. The succinct but comprehensive section on allergic contact dermatitis sets the pace by detailing all aspects of this entity and also highlights the finer points of the patch test. The brief but informative chapter on mastocytosis is well worth reading.
Both the acute and chronic presentations of hypersensitive pneumonitis are presented with a brief overview of the subject. Food and drug allergies are on the increase in modern society and have been meticulously dealt with but the chapter on anaphylaxis must be singled out for the thorough overview and the focus on current management protocols.
Asthma is represented by three chapters, namely occupational asthma, asthma conundrums and allergic bronchopulmonary aspergillosis. The first highlights the methodical approach required to detect the offending agent while the second focuses on the comorbidities associated with asthma. Allergic bronchopulmonary aspergillosis is extensively discussed but the organisation of material leaves the reader a little unsettled. Given the structure of the book and the constraints thereof, the brief presentation of eosinophilic disorders is understandable but it does not quite quench the reader's thirst for more.
HIV/AIDS is represented with a description of an acute HIV syndrome along with a stable HIV patient who developed hypersensitivity to abacavir. The authors of “Disorders of immune regulation” must be commended for the concise presentation of hyper-IgE syndrome. Autoimmune disorders, like rheumatoid arthritis and systemic sclerosis, are followed by immune-mediated rheumatic diseases like systemic lupus erythematous and antiphospholipid syndrome. This section is rounded off with immunodeficiency syndromes, in which humoral immune deficiency and chronic granulomatous disease are outlined. This informative segment is very valuable for those who do not ordinarily deal with such patients.
The strength of this book lies in the wealth of up-to-date information presented in a format which highlights the clinical approach to a patient. For a clinician like me, this style attempts to answer many questions. I am sure the typographical errors that have slipped through will be rectified in the next edition. This scholarly tome will be “ready reckoner” to all students of allergology, a complex discipline, in which many questions are still to be answered.
- © ERSJ Ltd
