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Instant Allergy.
  1. A N P SPEIGHT, Consultant paediatrician

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    Instant Allergy. By N Dahl, S Pedersen, and K Thestrup-Pedersen. (Pp 171; £15.95 paperback.) Blackwell Science, 1997. ISBN 9-780632-042326.

    This is an abbreviated version of a more definitive text by the same authors (Essential Allergy, Blackwell 1996) and is appropriately aimed at general paediatricians, physicians, and general practitioners who in reality manage the majority of cases of allergic disease in the population.

    There is a helpful glossary at the beginning which reminds readers what abbreviations like GM-CSF, ICAM-I, LTB-E, PGD-F, TNF, PRIST, RAST, and RIST stand for (just in case they had forgotten).

    I found the first chapter extremely useful as an up-to-date revision of basic immunology. Like the rest of the book it is clearly laid out and beautifully illustrated.

    Most of the rest of the book is devoted to atopic disease. There is a brief chapter on epidemiology and the increasing prevalence of atopic disease and others on the various types of allergens and investigations of allergic disease. Food intolerance, allergic rhinitis, and atopic dermatitis are all covered in brief chapters and there is a longer section on asthma. Most of this concerns adult asthma, but there is a separate section on childhood asthma which is clear and orthodox.

    It seems churlish to cavil at a tendency to dogmatism and oversimplification in a book of this brevity, but I felt like arguing at two points. The first was in the second chapter which develops the concept of allergy but does not attempt a definition, and thereafter talks almost solely of atopy as if the two terms were synonymous. This seems illogical as the authors themselves include “allergic contact dermatitis” in their mandate, which is a type IV not a type I reaction. The second point was the statement that “asthma which begins in childhood is usually allergic, while asthma which begins in adulthood is usually non-allergic.” While paediatricians still debate how they should be using the word “asthma”, there are many who would not accept the implication that all childhood asthma is allergic.

    Overall, this book should be an attractive proposition for a busy paediatrician requiring a brief update on the subject, and is almost worth purchasing for the first chapter alone.

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