From the Guidelines
Elevated Angiotensin-Converting Enzyme (ACE) readings can be caused by various factors, including sarcoidosis, liver diseases, hyperthyroidism, and certain medications, as well as conditions that affect renal perfusion and function, such as dehydration, bilateral renal artery stenosis, and congestive heart failure, as noted in the study by 1 and 1.
Possible Causes of Elevated ACE Readings
The following are possible causes of elevated ACE readings:
- Sarcoidosis: a condition characterized by the growth of granulomas in various parts of the body, which can lead to elevated ACE levels, as mentioned in the example answer.
- Liver diseases: such as cirrhosis, hepatitis, or fatty liver disease, which can affect the liver's ability to metabolize ACE, as noted in the example answer.
- Hyperthyroidism: an overactive thyroid gland, which can lead to increased ACE production, as mentioned in the example answer.
- Certain medications: such as ACE inhibitors, which can paradoxically cause temporary elevation in ACE levels, as noted in the study by 1.
- Conditions that affect renal perfusion and function: such as dehydration, bilateral renal artery stenosis, and congestive heart failure, which can lead to decreased renal function and elevated ACE levels, as noted in the study by 1 and 1.
Importance of Interpreting ACE Levels in Conjunction with Other Clinical Findings
It is essential to interpret ACE levels in conjunction with other clinical findings and tests, as elevated ACE levels can indicate various conditions, and a comprehensive evaluation is necessary to determine the underlying cause, as noted in the example answer.
Clinical Considerations
When evaluating a patient with an elevated ACE reading, it is crucial to consider the patient's medical history, physical examination, and laboratory results to determine the underlying cause of the elevated ACE level, as noted in the study by 1 and 1.
Recommendations
Based on the study by 1 and 1, it is recommended that patients with elevated ACE readings undergo a comprehensive evaluation to determine the underlying cause, and that ACE levels be interpreted in conjunction with other clinical findings and tests.
From the FDA Drug Label
ACE is a peptidyl dipeptidase that catalyzes the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. The possible causes of an elevated Angiotensin-Converting Enzyme (ACE) reading are not directly stated in the provided drug label. Key points:
- The label discusses the mechanism of action of lisinopril, an ACE inhibitor, but does not provide information on the causes of elevated ACE levels.
- The label describes the role of ACE in the renin-angiotensin-aldosterone system, but does not address the potential causes of elevated ACE readings 2.
From the Research
Possible Causes of Elevated Angiotensin-Converting Enzyme (ACE) Readings
- Sarcoidosis: Studies have shown that serum ACE is elevated in patients with sarcoidosis, with one study finding that 34% of patients had elevated ACE levels 3. Another study found that ACE phenotyping can be used to detect patients with systemic sarcoidosis, with elevated ACE levels being a marker for granulomatous diseases 4.
- Histoplasmosis: Elevated SACE activity has been observed in patients with acute pulmonary histoplasmosis, although elevations are less common and may only occur briefly following acute infection 5.
- Other pulmonary diseases: Elevated ACE levels have been noted in patients with tuberculosis, anthracosilicosis, and cancer, although these are less common than in sarcoidosis 6.
- Diabetes and renal insufficiency: Elevated ACE levels have been observed in patients with diabetes and renal insufficiency, although the significance of this is not fully understood 6.
- Ocular sarcoidosis: Elevated ACE levels have been observed in patients with optic nerve head granuloma and retinal vasculitis, which may be a forme fruste of ocular sarcoidosis 7.
- Granulomatous diseases: Elevated ACE levels are associated with increased risk of cardiovascular diseases and are also a marker for granulomatous diseases, suggesting that other granulomatous diseases may also cause elevated ACE readings 4.