ACE is usually requested to help diagnose and monitor sarcoidosis. It is often requested as part of an investigation into the cause of a group of long troubling symptoms that may or may not be due to sarcoidosis. ACE will be elevated in 50-80% of patients with active sarcoidosis. If it is initially elevated in someone with sarcoidosis, ACE can be requested at regular intervals to monitor the course of the disease and the effectiveness of corticosteroid treatment.
ACE is requested when you have signs or symptoms such as granulomas, a chronic cough or shortness of breath, red watery eyes, and/or joint pain that may be due to sarcoidosis or to another disorder. Sarcoidosis is most commonly seen between 20 and 40 years of age. Your doctor may request ACE with other tests such as an AFB culture or sputum culture (tests that can detect mycobacterial and fungal infections), to help differentiate between sarcoidosis and another granulomatous condition.
If when you were diagnosed with sarcoidosis, your initial ACE result was elevated, your doctor may request ACE testing at regular intervals to monitor the change in concentration over time.
If someone is under 20 years of age, then high ACE concentrations do not usually indicate disease. For those over 20 years of age, the concentrations of ACE within the blood does not tell you why ACE is elevated, what organs and/or body systems are involved, or how badly they are affected. ACE does not cause granulomas but may reflect their presence.
If ACE concentrations are high, other diseases have been ruled out and you have clinical symptoms of sarcoidosis, then it is likely that you have active sarcoidosis. About 20-50% of the time, however, sarcoidosis can be present without elevated ACE concentrations. This may be due to the disease being in an inactive state, due to an early detection ofsarcoidosis where the levels have not yet risen, or due to the fact that the cells do not produce increased amounts of ACE. An ACE result within the normal (reference) range canot be used to rule out the possibility of sarcoidosis. ACE concentrations are also less likely to be elevated in those with long term sarcoidosis.
High concentrations of ACE are often observed initially in sarcoidosis, which then decrease with time, which suggests the activity of the disease has decreased without obvious reason or as a result of therapy. Falling concentrations usually indicate a favourable prognosis. Rising concentrations of ACE on the other hand, may indicate either an early disease process that is progressing, or disease activity that is not responding to therapy.
ACE conversion of angiotensin I to angiotensin II is a normal regulatory process in the body. This process is targeted by drugs called ACE inhibitors that are commonly used in treating hypertension and diabetes. These drugs inhibit the conversion process, keeping the blood vessels more dilated and the blood pressure lower. ACE inhibitors are useful in managing hypertension but they are not monitored with ACE blood tests. They may however interfere with ACE measurements requested for other reasons.
Haemolysis (broken red blood cells) and hyperlipidaemia (excess fats) in the blood sample may falsely decrease the concentration of ACE within the blood. Decreased ACE concentrations may also be seen in patients with:
This article was last reviewed on 9 January 2012. | This article was last modified on 28 May 2015.
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