Angiotensin converting enzyme levels in sarcoidosis

Sarcoidal granulomas produce angiotensin-converting enzyme (ACE)

• elevated ACE levels are seen in 60% of sarcoidosis patients
• levels are influenced by gene polymorphism (1)

Although many clinicians check serum ACE levels, the importance of it in the diagnosis or managing sarcoidosis is debatable (1,2):

• as a diagnostic tool it has limited sensitivity and specificity (1)
• BTS guidelines also mention that serum ACE levels has a limited role in the diagnosis and it does not contribute to monitoring patients with pulmonary sarcoidosis when added to serial lung function and imaging (3)

Reference:

• 1. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357(21):2153-65
• 2.Dempsey OJ et al. Sarcoidosis. BMJ. 2009 Aug 28;339:b3206
• 3. Bradley B et al.Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008;63 Suppl 5:v1-58.