CSF-ACE activity in probable CNS neurosarcoidosis.
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.
Tahmoush
Albert J
AJ
Department of Neurology, MCP Hahnemann University, Philadelphia, PA 19102, USA. albert.tahmoush@drexel.edu
Amir
Mary S
MS
Connor
William W
WW
Farry
James K
JK
Didato
Sevastian
S
Ulhoa-Cintra
Alice
A
Vasas
Jennifer M
JM
Schwartzman
Robert J
RJ
Israel
Harold L
HL
Patrick
Herbert
H
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
D015415:Biomarkers; D007703:Peptidyl-Dipeptidase A