Serum angiotensin converting enzyme in sarcoidosis: clinical significance

The elevated activity of serum angiotensin converting enzyme (ACE) in sarcoidosis was usually reduced during steroid therapy but remained above the normal value (52 nmol-min-1-ml-1) in approximately a third of patients during the first year of therapy. ACE was elevated in 5 of 10 patients treated with steroids for at least four years. It was significantly higher in untreated patients (placebo group), who were subsequently placed on steroid therapy because of clinical deterioration, than in those remaining on placebo therapy. In general ACE tended to diminish with increasing duration of disease. The results suggest that serial study of ACE may be useful in the clinical management of sarcoidosis, including assessment of the degree of activity, the need for steroid therapy, therapeutic result and the prognosis.