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Lupus—molecular and cellular pathogenesis.
  1. D A ISENBERG, Centre for Rheumatology
  1. Bloomsbury Rheumatology Unit
  2. Department of Medicine
  3. University College London
  4. Arthur Stanley House, 40–50 Tottenham Street, London W1P 9PG

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    Lupus—molecular and cellular pathogenesis. Edited by Gary M Kammer, George C Tsokos. (Pp 720; $195). Totowa, NJ: The Human Press, 1999. ISBN0-89603-556-5.

    Given that there are already two major textbooks about systemic lupus erythematosus, you have to ask whether a further 700 page volume dedicated to this fascinating but relatively uncommon disease is really warranted. Indeed, extending this question, who is likely to buy a volume like this, which in reality covers a very broad spectrum of immunology (though this is essential given the diversity of defects reported in patients with lupus) but says little about clinical expression of the disease.

    However, for those interested in the causes of lupus, all of the major and relevant topics are here. Many of the chapters are well written, but the absence of colour plates detracts significantly from many of the figures especially those purporting to show immunofluorescence (really a waste of time in black and white) and others demonstrating molecular models.

    Although the editors have in the main, coaxed worthwhile efforts from most, though not all of their authors, the sequence of the chapters is decidedly odd. In particular chapters on B cells and antibodies appear at random throughout the book and it is not terribly clear why the main chapters on genetics, chapters 7 and 8, are so widely separated from other chapters with strong genetic connections such as chapter 17 (describing a genetic mechanism underlying deficient type 1 protein kinase A) and chapters 32–34 (on complement and Fc gamma receptor polymorphisms). Nor is it easy to understand why a chapter on the antiphospholipid antibody syndrome (albeit well written by Robert Roubey) is included but there is no mention of Sjögren's syndrome or other complicating clinical disorders.

    A great deal of effort has gone into the production of this volume, which contains 40 chapters mostly up to date (or at least as well as any textbook could be) and written by leaders in the field. If only the publishers had “invested” in some colour and the editors had lined up their chapters in a more logical way the end result would have been far more enjoyable.

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