[Practical value of serum angiotensin converting enzyme levels in sarcoidosis. Current results]

The authors analyze seric levels of Angiotensin converting enzyme (A.C.E.) with the method of Cushman and Cheung in 200 cases of sarcoidosis, and 130 cases of various bronchopulmonary diseases. All values equal or greater than 35.3 u/ml are considered high (M + 2 DS, control: 71 cases, 23.3 +/- 5.99 u/ml). 67% of sarcoid cases reveal high levels, mainly radiologic stages II and forms with evidence of clinic dissemination. A significant decrease of seric levels is observed in cases with spontaneous radiologic improvements, and in cases with radiologic amelioration under corticotherapy. A not-significant increase of seric levels appears in cases with radiologic aggravation. Radiologic stable forms have a variable evolution of their seric levels. Less than 10% of tuberculosis, asthma, chronic bronchitis and interstitial pneumopathies reveal elevated levels, but the prevalence reaches 61% in pneumoconiosis. However, the observed values never get over 60 u/ml, seric levels over this range being only noted in sarcoidosis. So, the determination of seric A.C.E. level has a positive interest in the diagnosis of sarcoidosis and in following sarcoidosis evolution. Its prognostic significance yet is difficult to evaluate.