A new and expanded edition of an old friend

Reading a new edition of an old book is akin to greeting an old friend. One hopes that the qualities that initially attracted one remain and those that did not have mellowed with time. This was my reaction upon opening the fourth edition of Pediatric Endocrinology, edited by Fima Lifshitz.The team of authors that contributed to Pediatric Endocrinology (4th edn) constitutes an impressive international group. The text is billed as appropriate for general pediatricians, but the focus of the chapters varies considerably; some are appropriate for general pediatricians and other much more detailed chapters are aimed at pediatric endocrinologists. Overall, this is a book for clinicians because it is light in molecular biology content.Pediatric Endocrinology (4th edn) contains welcome chapters on inborn errors of metabolism, autoimmune endocrinopathies (including an introduction to general immunology for the uninitiated and the perpetually confused) and non-traditional inheritance. There is even a chapter on coding and reimbursement issues, which, unfortunately, does not promise to make pediatric endocrinologists wealthy. The chapter on congenital adrenal hyperplasia would have been strengthened greatly by more discussion of newborn screening, which is becoming widely available and is a cause of anxiety for practitioners and parents alike, particularly in terms of preterm infants.One of the strengths of previous editions of this textbook has been the appendix section. The appendix on endocrine testing protocols and how they are interpreted was always useful and has been expanded in this edition. However, some procedures are already out of date because certain agents [e.g. Thyrotrophin-releasing hormone (TRH} and L-3, 4-dihydroxyphenylalanine (L-dopa)] are no longer available in the USA. The appendix on normative data has been expanded to include a multitude of growth charts of children with various conditions and anthropometric data that will be useful to dysmorphologists. At the beginning of Pediatric Endocrinology (4th edn) lies a section delineating websites that are cited in the text and will be useful to those involved in pediatric endocrinology. Because of the nature of the World Wide Web, such a chapter is not, and could never be, comprehensive and up to date. Nevertheless, it is useful, for practitioners and patients alike, as more information becomes available in electronic format.The quality of the chapters varies considerably. Most chapters were letter perfect, although some seemed to have escaped adequate standards of review and editing. I found considerable redundancy in the material, particularly in the discussions of calcium physiology. In general, the references were as up to date as can be expected in a printed textbook.The text is laced with black and white photographs depicting physical findings of various endocrine disorders. In many cases the quality of the photographs is disappointing, and, in some cases, it is sufficiently poor so as to obscure the point of the illustration. The histopathology photographs would have been greatly enhanced had they been in color. Undoubtedly this results from the tradeoff between publishing costs and photographic quality. However, if a publisher is to devote publishing space to a photograph, it might as well be one of good quality.Overall, despite some shortcomings, Pediatric Endocrinology (4th edn) is a textbook worth the investment, and handy to have on the shelf for both pediatricians and pediatric endocrinologist alike, although its more practical use will probably only be realized by pediatric endocrinologists.