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Serum Angiotensin Converting Enzyme (ACE)

Specimen Required

3-5cc Clotted Blood or Serum

Fasting Required

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Purpose of the Test

To sometimes help diagnose and monitor sarcoidosis and to help distinguish it from other diseases which show similar symptoms

When this test is required

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 X-rays, CT-Scan, tissue biopsies, 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.

What the Test Detects

Angiotensin converting enzyme (ACE) is an enzyme which helps regulate blood pressure. It converts angiotensin I (an inactive protein) to angiotensin II which causes arteries to contract, making them temporarily narrower and increasing the pressure of the blood flowing through them. ACE is produced throughout the body, but is present in especially high amounts within the lungs.  It is normally found at a high concentration in…Angiotensin converting enzyme (ACE) is an enzyme which helps regulate blood pressure. It converts angiotensin I (an inactive protein) to angiotensin II which causes arteries to contract, making them temporarily narrower and increasing the pressure of the blood flowing through them. ACE is produced throughout the body, but is present in especially high amounts within the lungs.  It is normally found at a high concentration in the bloodstream of those less than 20 years of age, and will usually then drop to lower concentrations in healthy adults.Increased amounts of ACE are sometimes produced by cells found at the outside borders of granulomas. Granulomas are a classic feature of sarcoidosis, a disorder (the cause of which is unknown) that often affects the lungs but may also affect many other body organs including the eyes, skin, nerves, liver, and heart. About 50-80% of patients with active sarcoidosis will have elevated concentrations of ACE in their bloodstream that will rise and fall as the severity of the disease changes. Granulomas, fibrosis, and an elevated ACE concentration may also be seen in infections such as leprosy and tuberculosis. The granulomas form around the invading bacteria in these infections and can also form around irritant particles in poisons such as beryllium, asbestos, and silicon. How is the sample collected for testing? A blood sample is taken by inserting a needle into a vein in the arm. Is any test preparation needed to ensure the quality of the sample? No test preparation is needed. See MoreSee Less

Preparation for the Test

None

Sample Requirements

A blood sample taken from a vein in your arm

Additional Notes

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.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: Chronic obstructive pulmonary disease (COPD) Cystic fibrosis Emphysema Lung cancer Starvation Steroid drug therapy HypothyroidismACE has been found at moderately increased concentrations in a variety of diseases and disorders such as: HIV Certain fungal diseases Diabetes mellitus Hyperthyroidism Lymphoma Alcoholic cirrhosis Gaucher’s disease (a rare inherited lipid metabolism disorder) Tuberculosis LeprosyThe ACE test is not useful in diagnosing or monitoring any of these disorders.