Uveitis associated with sarcoidosis and angiotensin converting enzyme

We evaluated serum angiotensin converting enzyme activity in three groups of patients as follows: 20 patients with systemic sarcoidosis and ophthalmic manifestations of the disease (Group 1); 27 patients with granulomatous uveitis and no evidence of systemic sarcoidosis (Group 2); and 17 patients with well-defined uveitis syndromes, both granulomatous and nongranulomatous (Group 3). Serum angiotensin converting enzyme activity in control subjects was 22.0 +/- 0.7 nanomol/min/ml (mean +/- S.E.). Compared to control subjects, serum angiotensin converting enzyme activity was significantly increased in Groups 1 and 2 for patients not using corticosteroids (57.9 +/- 7.4 and 41.5 +/- 4.4 nanomal/min/ml, respectively) as well as those using corticosteroids (40.3 +/- 5.1 and 35.6 +/- 4.8 nanomal/min/ml). Enzyme activity was not significantly different from controls for Group 3. Our study shows that the increase of serum angiotensin converting enzyme activity in some patients with granulomatous uveitis is strong evidence of sarcoid uveitis even in the absence of clinicoradiographic or histologic findings of systemic sarcoidosis.