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The lupus book. Daniel J Wallace. (Pp 271; US$25.) Oxford: Oxford University Press, 2000. ISBN 0-19-513281-5.
Lupus is a common and complex disease. This book is written for patients, but physicians and health professionals dealing with systemic lupus erythematosus will also find it useful. The author's aim is to provide readers with all necessary information and practical advice.
The first part deals with the definition, a brief historical review, and the epidemiology of the disease (the prevalence is probably still underestimated). The second is devoted to the mechanisms of inflammation and immunity, which are explained with welcome clarity, as are the causes of the disease. The third deals with genetic factors, “environmental villains”, and drugs.
The fourth part (“where and how the body can be affected by lupus”) is extremely important, as it takes the reader through the diagnostic process using an approach that considers symptoms and signs organ by organ: skin, joints, lungs, kidneys, etc. Laboratory tests are explained. The emphasis is on the neurological manifestations and much attention is paid to behavioural changes. Patients need to be made aware of the frequent difficulty the physician has in making a differential diagnosis.
The fifth part covers the treatment of systemic lupus erythematosus from a practical clinical perspective. It is emphasised that treatment is multifaceted and will not succeed unless all aspects are carefully considered: physical measures (avoiding exposure to the sun, regular exercise, rehabilitation), coping (the message is: “you can help conquer lupus”), and drugs. Interestingly, the text includes an exhaustive chart of herbs for antiarthritis agents, skin and gastrointestinal treatments, with claimed uses, active ingredients, and potential side effects.
Finally, the prognosis varies from person to person and is dependent on many factors, but patients who have a positive attitude and good coping mechanisms have a better prognosis.
The Lupus Book concludes with an exciting perspective for the year 2015, thanks to progress in healthcare systems and in research.
This second edition has benefited from numerous developments which have occurred in lupology over the past five years and new sections on apoptosis, cell signalling, lupus susceptibility genes, selective Cox-2 inhibitors, newer immunosuppressive treatments, and osteoporosis are included.
Concise and readable, it fulfils its objectives: all necessary information on basic knowledge and practical problems of the disease are given in a comprehensive manner, perhaps sometimes oversimplified, with an optimistic tone. The style is clear and precise, but nowhere dry. The answers to all the important and practical questions are included with no major omission. The glossary and the indexing are excellent. It is an important and valuable resource not only for patients but also for their care givers and for anybody concerned with lupus.
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