[Diagnostic, prognostic and developmental value of serum angiotensin converting enzyme in sarcoidosis].
Two hundred ninety three patients with mediastinal and pulmonary sarcoidosis were assayed one or more than one time for seric angiotensin converting enzyme (SACE) using the method of Cushman and Cheung (substrate hippuryl-histidyl-leucin). Seventy one normal subjects and 163 patients with various broncho-pulmonary diseases excluding sarcoidosis were used as control. SACE is elevated in 67.2 p. 100 of the patients with sarcoidosis and reflects the intra and extrathoracic extend of the granuloma. Elevated levels of SACE in pneumoconiosis diminishes the diagnostic value of this test (as well as the presence of a normal SACE level in some sarcoid patients). There is no correlation between SACE and the percentage of lymphocytes in bronchoalveolar lavage fluid. SACE returns to normal in cases with spontaneous radiological improvement, and reaches more elevated levels in cases with worsening. An initial low level of SACE is usually a sign of a future good evolution. An initial high level is an argument for starting on steroid treatment. Repeated dosages of SACE are useful for monitoring the steroid posology at the end of the treatment and for deciding to stop it. Persistence of low levels allows to stop the treatment. Re-elevation of SACE may correspond to a radiological and clinical relapse or to an isolated and resolvent rebound.
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D004796:Clinical Enzyme Tests; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000201:enzymology; D008297:Male; D008477:Mediastinal Diseases / Q000201:enzymology; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood*; D011009:Pneumoconiosis / Q000201:enzymology; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy / Q000201:enzymology*
D000305:Adrenal Cortex Hormones; D007703:Peptidyl-Dipeptidase A
Intérêt diagnostigue, pronostigue et évolutif de l'enzyme de conversion de l'angiotensine sérique dans la sarcoïdose.