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Serum angiotensin-converting enzyme in multiple sclerosis
C S Constantinescu1, D B Goodman, R I Grossman
1Department of Neurology, University of Pennsylvania, Philadelphia 19104-4283, USA.
Objective:
To determine the extent and significance of serum angiotensin-converting enzyme (ACE) elevation in multiple sclerosis (MS) and the correlation between serum ACE activity and clinical and magnetic resonance imaging (MRI) indicators of disease activity.
Design:
A retrospective cross-sectional study of 45 consecutive patients with clinically definite MS and a longitudinal study of 30 additional patients with clinically definite MS involved in a long-term study of neurologic function and MRI in MS.
Setting:
Comprehensive MS center of a tertiary care university hospital.
Subjects:
A total of 75 patients with clinically definite MS and 31 healthy controls.
Methods:
Serum ACE activity was measured using a spectrophotometric assay and correlated with clinical indicators of disease activity and with total cerebral MS lesion volume measured by MRI.
Results:
An elevated ACE activity was found in 17 (23%) of 75 patients with MS as compared with 2 (6%) of 31 healthy controls. Changes in serum ACE activity correlated with changes in total plaque volume on MRI.
Conclusions:
Serum ACE activity may be an indicator of disease activity in longitudinal analysis. Also, elevated ACE activity in a patient with otherwise typical MS need not raise suspicions of alternative diagnoses.