Value of measuring serum angiotensin I converting enzyme and serum lysozyme in the management of sarcoidosis.

Abstract

Serum angiotensin I converting enzyme (ACE) and lysozyme have been measured in 23 controls, 115 patients with sarcoidosis, and 64 with other chest diseases. Both enzymes were significantly raised in sarcoidosis. ACE was raised above the normal range in 21 of 72 (29%) patients with definite sarcoidosis and in 17 of 38 (45%) of those who were untreated and seen within one year of presentation. The rise discriminated usefully between those with stable and progressive disease (5% and 62% respectively). Lysozyme was raised in 50 of 72 (69%) patients with sarcoidosis but also in 11 of 54 (20%) patients with other chest diseases. Discrimination between stable and progressive disease was useful only if very high levels were considered. Five patients had serial measurements after treatment with oral steroids and showed a progressive fall in levels of both enzymes, but patients with other diseases also showed a significant fall within the normal range when so treated. Measurement of these enzymes may help in the management of some cases of sarcoidosis, but results require critical interpretation.

Serum angiotensin-converting enzyme in malignant lymphomas, leukaemia and multiple myeloma

“…The lack of non-significance of the lower SACE among prednisone-treated patients does not contradict other reports on a generally low SACE in steroid-treated nonsarcoid patients (Turton et al, 1979). The non-significance may be because the "prednisone-treated" patients in the present series included patients who had stopped treatment with prednisone within 2 months.…”

“…In sarcoidosis, the frequency of high SACE has been reported from 29% (Turton et al, 1979) to about 60% (Lieberman et al, 1979) (Lieberman & Beutler, 1976) whereas SACE is decreased in lung cancer (Silverstein et al, 1977;Lieberman et al, 1979) and untreated tuberculosis (Romer, 1980a). For leprosy the results are contradictory (Studdy et al, 1978;Lieberman et al, 1979).…”

Orofacial presentations of sarcoidosis – a case series and review of the literature

“…However the level of this enzyme is only raised in 50-80% of patients with sarcoidosis. 16,17 In the second case presented in this paper the serum ACE was initially within normal limits but later became raised with the progression of the condition. The meas urement of this enzyme may be useful in monitoring the response to treatment.…”

Circulating soluble intercellular adhesion molecule-1 (sICAM-1) in patients with sarcoidosis

“…The prognosis is generally good for the acute form of sarcoidosis. In contrast, a subset of patients with sarcoidosis have a more chronic, progressive and relapsing illness; 20-30% of sarcoidosis patients are left with permanent lung dysfunction, and the disease is fatal in 5-10% [39][40][41]. Many attempts have been made to find markers of disease activity in sarcoidosis, which may define patients at risk for irreversible lung damage.…”

“…Many attempts have been made to find markers of disease activity in sarcoidosis, which may define patients at risk for irreversible lung damage. In the search for prognostic factors, SACE has been most extensively studied [41,42]. However, SACE appears not to be a prognostic factor in sarcoidosis [42].…”