By James T. Cassidy, Rose E. Petty, Ronald M. Laxer, and Carol B. Lindsley 6th ed, 800 pp, $224.95 Philadelphia, PA, Elsevier/Saunders, 2011 ISBN-13: 978-1-4160-6581-4 Pediatric rheumatology is still a new subspecialty; the first board certification was granted in 1992. The Textbook of Pediatric Rheumatology has been and still is the textbook of choice on this subject. The chapter contributors include 64 leaders in the field who have written seminal articles on subjects such as neonatal lupus (Buyon), juvenile dermatomyositis (Rider), scleroderma (Zulian), and periodic fever syndromes (Kastner). This edition was published in 2011, shortly prior to James Cassidy's death on January 21, 2012. The sixth edition now includes color illustrations, 29 new contributors, and 11 new chapters, with information on the use of biologics that were not available prior to the publication of the fifth edition. Section 1 introduces the reader to key concepts—basic immunology, pharmacology (including biologic medications), trial design, and assessment of pediatric health, disease activity, and quality of life. Section 2 details multiple categories of childhood arthritis and associated uveitis. Section 3 is devoted to connective tissue diseases, section 4 to systemic vasculitis, and section 5 to infectious arthritides. Section 6 provides expanded information on periodic fever syndromes, other inherited autoinflammatory disorders, and autoinflammatory bone disorders. Macrophage activation syndrome (MAS) is now placed in this section instead of under systemic arthritis, possibly to emphasize its relationship to the autoinflammatory disorders. Section 7 describes noninflammatory causes of musculoskeletal pain. Purchasers receive a code allowing access to the complete contents online. The electronic version is helpful in that the contents are searchable and allow the reader to view tables and images in larger size; the electronic version also includes the full references for each chapter. To decrease printing costs, large numbers of references—many of them citing reviews—appear only in the electronic version, which makes it impossible to see the sources supporting opinions expressed in the text without going online. Much of pediatric rheumatology literature is case-based, because it is difficult to perform large multicenter clinical trials in rare pediatric diseases. At times, the Textbook of Pediatric Rheumatology seems to rely heavily on limited data, anecdotal information, or both to discuss pathogenesis and treatment, but this may be a reflection of the overall paucity of investigative research available in pediatric rheumatology. For instance, the 3-page section on juvenile dermatomyositis discusses theories of birth seasonality, infections, medications, immunizations, stressful life events, unusual sun exposure, chemicals, animal contact, weight training, dietary supplement use, and UV light exposure without summation or discussion of the weight of the evidence to help determine the importance of these competing theories. A discussion of enthesitis-related arthritis (ERA) mentions that “by anecdotal report, methotrexate appears to be less effective in treating ERA than other types of [juvenile idiopathic arthritis]” (p 284). At other times, in areas with limited evidence, the authors use their own experience; eg, “Based on the authors' own experience and review of the literature, MAS occurs with equal frequency in boys and girls” (p 674). The areas with anecdotal data or author's experience are labeled as such, so there is no confusion as to the type of evidence being presented. Overall, the Textbook of Pediatric Rheumatology is a quality textbook with improved information on new therapies for rheumatic conditions as well as beautiful new color illustrations and diagrams. It is the textbook of choice for studying and practicing pediatric rheumatology, and all attendings and fellows in pediatric rheumatology should own it, as should practitioners of adult rheumatology who may care for children. For the next edition, the editors should consider including the full references in the print version; expanded chapters on evolving topics such as lipodystrophy and osteoporosis would also be helpful, as would clarification of duplicated information such as that found in chapters 43 and 44. Rapid advances in pediatric rheumatology make it likely that future editions will contain new information on etiology, pathogenesis, and treatment. Back to top Article Information Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Reed reported receiving money for consulting from Genentech and that her institution has received grant money from the National Institutes of Health (NIH), Lupus Foundation, Arthritis Foundation, and the State of Minnesota. Dr Robinson reported that her institution has received grant money from Cincinnati Children's Hospital (NIH P30 grant).
– American Medical Association
Published: Nov 28, 2012