Pathology Associates Of Lexington, P.A.

ACE Test

Angiotensin Converting Enzyme, serum

An enzyme localized in lung, kidney, and systemic vessels (and potentially leaked into the blood serum) which is used as a screening test when lung nodules are found: 50-60% of patients with sarcoidosis have elevated ACE... up to 85% if the sarcoidal disease is in an active phase (and there is a tendency for the ACE level to be proportional to the total-body granuloma load as assessed by gallium scan) ...only 11% if inactive.

NOT CAUSING INCREASED values/levels

possibly NOT sarcoid if not elevated
sarcoid very localized, such as skin-only, may have normal levels may not be elevated.
BUT, cases with even fairly bulky disease (new cases) can have normal ACE levels [LMC-01-2412]
most cases of TB or atypical mycobacteria
lung cancer¹
malignant lymphoma¹
Wegener's granulomatosis
idiopathic granulomatous endometriopathy [LMC-05-2084]
granulomatous hepatitis, non-sarcoidal
lymphomatoid granulomatosis
Crohn's disease
midline granulomatous disease
fungal nodules of lung
beryllium granulomas of lung

Causes of INCREASED Values/Levels

sarcoidosis(50-60% of cases)... 85% of active cases (sarcoid may also elevate lysozyme)
false positive cases...elevations in apparent normals, 2-4%¹
Gauche's disease (100% of cases¹)
may be in >24% with diabetes mellitus¹
may be in 81% with hyperthyroidism¹
chronic renal disease¹
25% of cirrhosis cases¹
leprosy (53%¹
some cases of amyloidosis¹
>20% silicosis cases¹
75% of berylliosis cases¹
some cases of multiple myeloma
some cases of primary biliary cirrhosis (PBC)
some cases of Paget's disease of bone
some cases of tuberculosis¹
elevated levels do not absolutely rule out Wegener's, TB, fungal, lymphomatoid graulomatosis, or midline granulomatous disease...some of these cases can cause significant elevations

Test SYNONYMS

Other names for this exact or approximate agent are: ACE

References:

Wallach J, Interp. of Diagnostic Tests, 7th Ed., 2000.

(posted 9 February 2002; latest addition 14 March 2005)