Case studies in immunology: A clinical companion, 5th Ed. by Raif Geha and the late Fred Rosen

Abstract

Raif Geha and the late Fred Rosen, Garland Science, New York and London, 2008, 344 pp., ISBN 0-8153-4145-8/9-780815-341451, $49.95. E. J. Wood*, * Centre for Bioscience, The Higher Education Academy, University of Leeds, Leeds LS2 9JT, United Kingdom. This case studies volume is aimed mostly at the more advance medical students but would also be of interest to those taking immunology courses. It contains 47 case studies of a variety of immunological diseases both common and rare, and, the authors say, is updated and has some new cases compared with the previous editions. Each case gives initially some background, then presents the case (based on real patients—the names are changed to protect the innocent), and then a description is given followed by 4–6 questions for students to self-test their understanding. Answers are given at the back of the book. Many cases have pictures of the patients plus histology and other clinical information. Most cases are accompanied by excellent diagrams. This is not simple immunology (perhaps immunology is never simple anyway), but the cases are complicated and required a great deal of insight and knowledge. To give just one example: “Deficiency of the C8 component of complement,” the introduction gives details of the lytic part of the complement cascade with diagrams and electron micrographs, and the following description, after the case has been presented, tells us about the frequency of complement component deficiencies in various ethnic populations along with the known molecular biology of the mutations for C8 deficiency. One of the questions at the end is, “Hemolytic complement levels were determined by measuring the CH50. What is that and how is the test performed?” This is not stated in the text and indicates the level of sophistication and background knowledge expected. There is a lot of biochemistry in the book, but of course the emphasis is mainly clinical/immunological. Some examples of cases presented are as follows: interleukin-1 receptor-associated kinase deficiency; activation-induced cytidine deaminase deficiency; multiple myeloma; mixed essential cryoglobulinemia; lepromatous leprosy; AIDS; contact sensitivity to poison ivy; hemolyic disease of the newborn; graft-versus-host disease. The book will be useful to medical students toward the end of their clinical training and to those on a clinical immunology track, but those teaching immunology courses will also find that the content will provide useful, real, examples to illustrate their lectures (or use in problem-based sessions).