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The Granulomatous Disorders.
  1. M WISELKA, Consultant in Infectious Diseases
  1. Department of Infection and Tropical Medicine
  2. Leicester Royal Infirmary, UK

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    The Granulomatous Disorders. Edited by D Geraint James and Alimuddin Zumla. (Pp 616; £150.) Cambridge University Press, 1999. ISBN 0-521-592216.***

    This is a review of the pathology of granulomas and granulomatous disease. The editors have a distinguished background in infectious diseases and sarcoidosis and the contributors include leading experts with a truly global perspective.

    Granulomatous inflammation is a pathological response to a number of stimuli including infectious agents, foreign body reaction, and diseases of unknown aetiology. Many of these conditions have multisystem manifestations and the editors faced a daunting task in the organisation of this review.

    The text is divided into four sections dealing with the biology of granulomas, infectious granulomas, granulomas and disease, and granulomas and body systems. This necessarily leads to a substantial amount of repetition, however it does ensure that disorders are discussed both by aetiology and by systems.

    Part 1, which deals with the biology of granulomas, is perhaps the most satisfying section of the text and includes a discussion of the biology and immunology of granulomas, pathological consequences and an excellent and well illustrated chapter on imaging. I found the remainder of the book somewhat disappointing as it included little information that could not be gleaned from a standard medical or infectious diseases textbook. Many of the chapters are simply overviews of irrespective disorders or systems and do not include the in-depth discussion of each condition that one would expect in a text of this size and price.

    The chapters vary considerably in style and presentation, however most are well referenced up to 1997 and comprehensively illustrated, although mainly in black and white. Some of the coloured plates are poorly reproduced and more comprehensive explanation in the legends would be helpful. There are many serious errors in the indexing.

    So who is this book aimed for? Many clinicians and researchers will be faced with granulomatous disorders in their daily practice and this text is a useful overview. Nevertheless, many will find it contains little new information or critical discussion of current research. This is a book for the library rather than the office.

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