ACE in sarcoidosis

Q: Serum angiotensin converting enzyme (ACE) has a very high sensitivity and specificity to diagnose sarcoidosis?

A) True

B) False

Answer: B

None of the serologic markers including ACE, adenosine deaminase, serum amyloid A, soluble interleukin-2 receptor, or D-dimer have shown any definite evidence to exclusively diagnose sarcoidosis. Although 3/4th of the patients with sarcoidosis have high ACE levels, it has very poor sensitivity and unreliable specificity. 

Other diseases which can also have high ACE levels include Asbestosis, Beryllium disease, Coccidioidomycosis, Diabetes mellitus (DM), Hodgkin disease, Hypersensitivity pneumonitis, Hyperthyroidism, Leprosy, Lung cancer, Primary biliary cirrhosis (PBC), Silicosis and Tuberculosis (TB).

#sarcoidosis

References:

1. Studdy PR, Bird R. Serum angiotensin converting enzyme in sarcoidosis-its value in present clinical practice. Ann Clin Biochem 1989; 26 ( Pt 1):13. 

2. Baughman RP. Pulmonary sarcoidosis. Clin Chest Med 2004; 25:521. 

3. Ungprasert P, Carmona EM, Crowson CS, Matteson EL. Diagnostic Utility of Angiotensin-Converting Enzyme in Sarcoidosis: A Population-Based Study. Lung 2016; 194:91.