Related Experiment Videos
CSF-ACE activity in probable CNS neurosarcoidosis
Albert J Tahmoush1, Mary S Amir, William W Connor
1Department of Neurology, MCP Hahnemann University, Philadelphia, PA 19102, USA. albert.tahmoush@drexel.edu
Summary
Cerebrospinal fluid-angiotensin-converting enzyme (CSF-ACE) activity is elevated in patients with probable central nervous system (CNS) neurosarcoidosis. This marker shows high specificity for diagnosing CNS neurosarcoidosis when MRI reveals enhancing lesions.
Area of Science:
- Neurology
- Biochemistry
- Immunology
Background:
- Central nervous system (CNS) neurosarcoidosis is a rare granulomatous disease.
- Diagnostic criteria for CNS neurosarcoidosis are complex and often require invasive procedures.
- Cerebrospinal fluid-angiotensin-converting enzyme (CSF-ACE) is a potential biomarker.
Purpose of the Study:
- To evaluate the diagnostic utility of CSF-ACE activity in identifying probable CNS neurosarcoidosis.
- To determine the sensitivity and specificity of CSF-ACE in this patient population.
Main Methods:
- A case-control study was conducted.
- CSF-ACE activity was measured in 11 patients with probable CNS neurosarcoidosis and 207 controls.
- Diagnostic criteria included biopsy-proven systemic sarcoidosis, neurological deficits, and MRI-enhancing lesions, with exclusion of other causes.
Main Results:
- CSF-ACE activity was significantly higher in patients with probable CNS neurosarcoidosis (9.5 +/- 6.9 nmol/mL/min) compared to controls (2.9 +/- 2.7 nmol/mL/min).
- An optimal CSF-ACE activity threshold of 8 nmol/mL/min yielded a sensitivity of 55% and specificity of 94%.
- Elevated CSF-ACE activity is strongly associated with CNS neurosarcoidosis.
Conclusions:
- CSF-ACE activity serves as a valuable biochemical marker for probable CNS neurosarcoidosis.
- The marker is particularly useful when magnetic resonance imaging (MRI) demonstrates diffuse enhancing lesions in the brain or spinal cord.
- CSF-ACE aids in the non-invasive diagnosis of neurosarcoidosis.