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Doody's Review ServiceReviewer: Mark Rhoads, MD (Ochsner Clinic Foundation)
Description: This book details the proceedings of a symposium held in November 2001 focusing on autoimmune GI/Liver diseases. Some reviews are comprehensive while other presentations are brief and poorly illustrated. Particularly instructive and enjoyable are the chapters on molecular mimicry by Vergani et al., on autoimmune enteropathy by Seidman et al., and on the role of enterocytes in intestinal and systemic autoimmunity by Eisenstein and Lebenthal. The chapter on pathology of ulcerative colitis and Crohn's disease is excellent and is one of the few that are well illustrated.
Purpose: The purpose is to address chronic autoimmune diseases in children, including autoimmune hepatitis, autoimmune enteropathy, primary sclerosing cholangitis and inflammatory bowel disease. Both clinical and basic science research are presented, although the majority of presentations are clinical in nature. The book's important objectives are successfully met.
Audience: The book is aimed at clinicians, particularly pediatric gastroenterologists, but would also be useful for investigators who study autoimmune diseases. Many of the authors are internationally recognized experts. Clinicians who treat IBD would especially profit from this book.
Features: The book has several sections which contain excellent 3-10 page reviews on liver and bile duct autoimmunity, inflammatory bowel disease and chronic autoimmune enteropathy. There are subsections that deal with the basic mechanisms of epithelial antigen presentation, T-cell responses, and perpetuation of autoimmunity. Interspersed are short vignettes on these topics. At the end are a number of poster presentations that are of variable quality. The basic science mechanisms of autoimmunity are not clearly presented or diagrammed to benefit novices in the field. As a whole, there are too few diagrams and illustrations.
Assessment: Overall, the book is interesting and easy to read. The longer reviews are excellent. A couple of the smaller vignettes are fascinating, including a description of a number of children who developed autoimmune liver disease after liver transplantation. I also enjoyed the reviews of medical therapy for inflammatory bowel disease, including short articles on budesonide and antitumor necrosis factor therapy. My only criticisms are that there should be more illustrations and that some of the reviews express opinions that are somewhat controversial. (These include the statement that "azathioprine is often hepatotoxic," and the view that alternate day therapy with steroids for inflammatory bowel disease is unsubstantiated.) To my knowledge, there are no other books in the field that are relevant to children with autoimmune liver disease or enteropathy. The book should prove to be useful.