Is an Angiotensin-Converting Enzyme (ACE) level of 82, with a lab reference high of 67, considered very high?

From the Guidelines

An ACE level of 82, with a lab reference high of 67, is indeed considered very high and warrants further evaluation. This result indicates significantly elevated angiotensin converting enzyme (ACE) levels, which can be associated with certain medical conditions, such as sarcoidosis, an inflammatory disease that can affect multiple organs, as noted in the european position paper on rhinosinusitis and nasal polyps 2020 1. The most common cause of a markedly elevated ACE level is sarcoidosis, and elevated serum levels of ACE are usually associated with more aggressive disease and multiple-organ involvement 1.

While this result strongly suggests further evaluation is needed, it's essential to note that ACE levels can be elevated in other conditions as well, including some liver diseases, hyperthyroidism, and certain cancers. Additionally, ACE inhibitor medications can artificially lower ACE levels, potentially masking true elevations. Next steps typically involve:

• A thorough medical history and physical examination
• Chest X-ray and/or CT scan to look for characteristic signs of sarcoidosis
• Possibly additional blood tests or tissue biopsies, depending on symptoms and initial findings It's crucial to interpret this result in the context of the patient's overall clinical picture, as a single elevated ACE level is not diagnostic on its own, but it can be an important clue in guiding further investigation and potential diagnosis, as suggested by the study on sarcoidosis diagnosis and evaluation 1.

From the Research

Angiotensin-Converting Enzyme (ACE) Levels

• The provided ACE level of 82, with a lab reference high of 67, indicates an elevated ACE level 2, 3, 4.
• Elevated ACE levels have been associated with various conditions, including sarcoidosis, granulomatous diseases, and endothelial abnormalities 2, 4.
• However, the studies provided do not specifically define an ACE level of 82 as "very high" 2, 3, 4.
• One study mentions that high plasma levels of ACE (> 50 U/L) were found in 57 patients, but it does not provide a clear definition of "very high" ACE levels 3.
• Another study discusses the clinical applications and laboratory investigations of ACE, but it does not provide a specific definition of "very high" ACE levels 4.

Comparison to Reference Values

• The lab reference high of 67 suggests that an ACE level of 82 is above the normal range 2, 3, 4.
• However, without more information on the specific reference range and the units used to measure ACE levels, it is difficult to determine the significance of an ACE level of 82 2, 3, 4.
• The studies provided do not offer a clear comparison to reference values or a definition of "very high" ACE levels 2, 3, 4.

Clinical Significance

• Elevated ACE levels have been associated with various clinical conditions, including sarcoidosis, granulomatous diseases, and endothelial abnormalities 2, 4.
• However, the clinical significance of an ACE level of 82, with a lab reference high of 67, is not clearly defined in the provided studies 2, 3, 4.
• Further evaluation and consideration of individual patient factors are necessary to determine the clinical significance of an elevated ACE level 2, 3, 4.