Book Review

Systemic Vasculitis: The Biological Basis

N Engl J Med 1993; 329:740September 2, 1993

Article

Systemic Vasculitis: The Biological Basis
Edited by E. Carwile Leroy. 583 pp., illustrated. New York, Marcel Dekker, 1993. $175. ISBN: 0-8247-8650-5

The history of vasculitis is replete with redefinition, “evolution,” and recategorization. In the past few years, such changes have been promoted by the recognition of antineutrophil cytoplasmic autoantibodies, which are found in the blood of patients with various types of vasculitis as well as necrotizing glomerulonephritis. This subject and the role of the neutrophil in systemic vasculitis are clinically relevant and well addressed in one of the chapters in Systemic Vasculitis. Other areas covered in the book include the role of vascular endothelium in the pathogenesis of vasculitis, lymphocyte-endothelium interactions, and the role of monocytes, macrophages, and mast cells in vasculitis. The microvasculature is examined from both the anatomical and the functional standpoint. One chapter is devoted to an explanation of the internal elastic membrane and its potential role in vasculitis.

Clinical aspects of vasculitis are covered in a brief overview that becomes more focused as individual organ systems are examined -- i.e., the skin, lung, heart, kidneys, gastrointestinal system, and nervous system. This approach is a departure from that of the usual textbook on vasculitis, in which the syndrome is emphasized and the organ associations are part of the secondary descriptions. I think that this book will be a useful addition to the libraries of those interested in the subject. Indeed, its extensive focus on putative pathogenetic mechanisms and its analysis of vasculitic manifestations according to organ systems rather than vasculitic syndromes provide the reader easy access to knowledge that is usually fragmented and difficult to obtain in concise form.

Seymour Rosen, M.D.
Beth Israel Hospital, Boston, MA 02215