This reference atlas provides text on both diagnosis and management, plus excellent visual material for the entire range of systemic diseases affecting the liver. It will help the clinician to recognize the symptoms and manage the patient before serious damage can occur.
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With the current plethora of comprehensive textbooks on liver disease, the question whether another book of this type is needed should be addressed. Gitlin's book, The Liver and Systemic Disease, is not an original concept, since there is already at least one similar book available. Nevertheless, in its favor, this textbook focuses on a specialty but is also comprehensive, and so it will be useful not only to hepatologists but also to all clinicians involved in treating disorders complicated by hepatic abnormalities.
The book is attractively produced. The histologic photographs are very clear and useful. In Wilcox's chapter on AIDS, excellent photographs are accompanied by line drawings to help explain the radiographic and angiographic abnormalities shown. In most chapters, authors have provided very useful tables for differential diagnoses.
However, I have some criticisms. Inevitably, in books with multiple authors there is unnecessary and irritating repetition, as in the descriptions of nodular regenerative hyperplasia and hepatitis C virus in different chapters of this book. There is also unevenness among the descriptions of biochemical and pathophysiologic mechanisms. In addition, there are some surprising omissions, such as the lack of discussion of the apparent absence of association between IgA nephropathy and chronic alcoholism and of the beneficial use of the transjugular intrahepatic portosystemic shunt in the management of hydrothorax.
I would be surprised if specialists such as nephrologists or rheumatologists would buy The Liver and Systemic Disease for the use of a single chapter. In contrast, general internists might find the book useful as a shortcut to answers to many of their problems.
Reviewed by Laurence Blendis, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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