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Handbook of Diagnostic Endocrinology. Ishwarlal Jialal, William E. Winter, and Daniel W. Chan, eds. Washington, DC: AACC Press, 1999, 250 pp., $36.00. ISBN 1-890883-08-5.

Hospital Sainte-Justine, Montreal, Quebec H3T 1C5, Canada

The purpose of a handbook is to be an easily available guide for rapid consultation. In their introduction, the editors of the Handbook of Diagnostic Endocrinology recognize and discuss the need for such a tool for laboratory professionals as an aid in the investigation and management of endocrine disorders. The editors and contributors to this handbook are all well-known and respected clinicians and scientists in their fields. This brief overview of some of the chapters highlights the strengths and weaknesses of this handbook.

From an organizational perspective, the handbook is divided into nine chapters, each covering nearly every disorder of a specific endocrine tissue or endocrine axis. One chapter covers lipoprotein-associated diseases with, however, no reference to an endocrine control. All chapters are structured in the form of paragraphs. This format sometimes makes the extraction of essential information difficult and, in my opinion, defeats the purpose of the handbook. Each chapter begin with a short recapitulation of the physiology and biochemistry of the gland or axis being discussed. The information given is sometimes limited. For example, in Chapter 1, entitled "Laboratory Investigation of Disorders of the Pituitary Gland", the description of growth hormone deficiency is given only six lines and is followed immediately by secondary thyroid-stimulating hormone deficiency (given four lines), which in turn is followed by corticotropin deficiency. To be fully appreciated, the information presented in the section on the investigation of hypopituitarism would benefit from a more accessible format.

Chapter 2, which addresses thyroid disease, is divided into four broad sections: physiology of the thyroid-pituitary-hypothalamic axis, metabolism and physiological variations, modification of thyroid function in nonthyroidal and thyroidal disease states, and laboratory tests used in the assessment of thyroid function. Each section gives sufficient information in a logical sequence. Tables and simple algorithms help the reader focus on essential information in the scope of a handbook. Interestingly, although the authors give importance to the free thyroxine index, which has a tendency to disappear from the diagnostic tests menu, they do not discuss the presence of heterophilic antibodies, which are increasingly recognized as interfering with thyroid function tests, nor do they mention the availability of molecular diagnostic tools. Topics such as these might be considered in any future edition of the handbook.

Chapters 3 and 6, respectively entitled "Laboratory Approaches to Diseases of the Adrenal Cortex and Adrenal Medulla" and "Evaluation of Hypoglycemia and Hyperglycemia", are well structured and comprehensive. Chapter 3, the major chapter of the book, merits attention. The author has made adequate use of simple steroid synthesis pathways in which he has highlighted possible metabolic blocks. He has also used clear step-by-step appropriately placed figures to summarize the diagnostic workup of suspected glucocorticoid deficiency (Fig. 3, on page 55) or excess (Fig. 5, on page 66). Chapter 6, which covers an equally difficult subject, follows the same format. The style and structure of this chapter efficiently directs the uninformed reader through the vast array of etiologies of disturbances of glucose and carbohydrate metabolism.

Chapter 5 gives a clear and concise summary of bone physiology and related diseases. It contains two tables that cursorily outline the differential diagnosis of hypercalcemia and hypocalcemia. Very little is said about inherited bone diseases related to either the mineral phase or the matrix. The bibliography is particularly abundant.

In conclusion, this handbook contains a wealth of topical information on diagnostic endocrinology and deserves to be on the bookshelves of laboratorians. However, its format makes it more a precis than a handbook.

This Article Extract Full Text (PDF) Submit an electronic Letter to the Editor about this paper Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Delvin, E. Search for Related Content PubMed Articles by Delvin, E.