Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
 Home | Pathology Group MembersOur Hospital  Search This Website:
        ACE Test
Angiotensin Converting Enzyme, serum
Sarcoidosis can be lethal (a case in former pro football player, here). An enzyme localized in lung, kidney, and systemic vessels (and potentially leaked into the blood serum) which is used as a screening test when lung nodules are found: 50-60% of patients with sarcoidosis have elevated ACE... up to 85% if the sarcoidal disease is in an active phase (and there is a tendency for the ACE level to be proportional to the total-body granuloma load as assessed by gallium scan) ...only 11% if inactive. Or it may be used after biopsies anywhere show granulomatous disease, especially if the tissue contains Schaumann bodies or crystals, asteroid bodies, or Hamazaki-Wesenberg (H-W) bodies [photos HERE].


  • possibly NOT sarcoid if not elevated
  • sarcoid very localized, such as skin-only, may have normal levels may not be elevated.
  • BUT, cases with even fairly bulky disease (new cases) can have normal ACE levels [LMC-01-2412]
  • most cases of TB or atypical mycobacteria
  • lung cancer1
  • malignant lymphoma1
  • Wegener's granulomatosis
  • idiopathic granulomatous endometriopathy [LMC-05-2084]
  • granulomatous hepatitis, non-sarcoidal
  • lymphomatoid granulomatosis
  • Crohn's disease
  • midline granulomatous disease
  • fungal nodules of lung
  • beryllium granulomas of lung

Causes of INCREASED Values/Levels

  • sarcoidosis(50-60% of cases)... 85% of active cases (sarcoid may also elevate lysozyme)
  • false positive cases...elevations in apparent normals, 2-4%1
  • Gauche's disease (100% of cases1)
  • may be in >24% with diabetes mellitus1
  • may be in 81% with hyperthyroidism1
  • chronic renal disease1
  • 25% of cirrhosis cases1
  • leprosy (53%1
  • some cases of amyloidosis1
  • >20% silicosis cases1
  • 75% of berylliosis cases1
  • some cases of multiple myeloma
  • some cases of primary biliary cirrhosis  (PBC)
  • some cases of Paget's disease of bone
  • some cases of tuberculosis1
  • elevated levels do not absolutely rule out Wegener's, TB, fungal, lymphomatoid graulomatosis, or midline granulomatous disease...some of these cases can cause significant elevations


Other names for this exact or approximate agent are:   ACE


  1. Wallach J, Interp. of Diagnostic Tests, 7th Ed., 2000.


(posted 9 February 2002; latest addition 6 October 2011)
© Copyright 1999 - 2006, all rights reserved, Pathology Associates Of Lexington, P.A.