by Marian W. Ropes, 173 pp, with illus, $12.50, Cambridge, Mass, Harvard University Press, 1976.
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This small, readable volume provides a clinical review of systemic lupus erythematosus (SLE), but it is primarily a report of the author's experience with 142 patients with this disease seen at the Massachusetts General Hospital between 1932 and 1966 and a statement of her opinions about the disease and its management based on that experience. This group of patients is remarkable because of the length of follow-up and the observations recorded in many patients with major organ involvement without corticosteroid treatment.
The author's principal message is clear: that the course of SLE is highly variable and unpredictable, with a favorable outlook for survival for ten years or more in the majority of cases; that remissions occur and may be prolonged without corticosteroid therapy; and that rigorous proof is lacking of the efficacy of toxic drugs, including corticosteroids, in extending survival. The "conservative" program of treatment that the author advocates, using
Townes AS. Systemic Lupus Erythematosus. JAMA. 1977;237(4):387. doi:10.1001/jama.1977.03270310073015