title: CSF-ACE activity in probable CNS neurosarcoidosis.
abstract: OBJECTIVE
  To redefine the utility of CSF-ACE as a selective indicator of probable CNS neurosarcoidosis.
  
  
  METHODS
  The diagnosis of probable CNS neurosarcoidosis required: (a) biopsy evidence of systemic sarcoidosis, (b) cortical, brainstem, and/or spinal cord deficits, (c) enhancing lesions on brain and/or spinal cord MRI, and (d) exclusion of other etiologies which could account for the neurological deficits. Radioassay measurement of CSF-ACE activity was performed in 11 patients who met our criteria for probable CNS neurosarcoidosis and 207 control patients.
  
  
  RESULTS
  The M +/- SD for CSF-ACE activity was significantly higher (p < 0.05) for the 11 probable CNS neurosarcoidosis patients (9.5 +/- 6.9 nmol/mL/min) than for the control patients (2.9 +/- 2.7 nmol/mL/min). The optimal CSF-ACE activity discriminator value was 8 nmol/mL/min. At this value, the sensitivity and specificity of CSF-ACE activity was 55% and 94%, respectively.
  
  
  CONCLUSIONS
  CSF-ACE activity is a useful biochemical marker of probable CNS neurosarcoidosis when brain and/or spinal cord MRI show diffuse enhancing lesions.
authors.affiliation: Department of Neurology, MCP Hahnemann University, Philadelphia, PA 19102, USA. albert.tahmoush@drexel.edu
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Tahmoush
authors.forename: Mary S
authors.initials: MS
authors.lastname: Amir
authors.forename: William W
authors.initials: WW
authors.lastname: Connor
authors.forename: James K
authors.initials: JK
authors.lastname: Farry
authors.forename: Sevastian
authors.initials: S
authors.lastname: Didato
authors.forename: Alice
authors.initials: A
authors.lastname: Ulhoa-Cintra
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Vasas
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Schwartzman
authors.forename: Harold L
authors.initials: HL
authors.lastname: Israel
authors.forename: Herbert
authors.initials: H
authors.lastname: Patrick
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002490:Central Nervous System / Q000473:pathology; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D007703:Peptidyl-Dipeptidase A