What diseases can show a high Angiotensin-Converting Enzyme (ACE) test result?

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Dainyal Siddiqui, MD

Internal Medicine

MJ

Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: April 7, 2025 • View editorial policy

Differential Diagnosis for a High ACE Test Result

A high Angiotensin-Converting Enzyme (ACE) test result can be indicative of several conditions. Here's a categorized differential diagnosis:

  • Single Most Likely Diagnosis

    • Sarcoidosis: This is the most common condition associated with elevated ACE levels. Sarcoidosis is a systemic granulomatous disease that can affect multiple organs, including the lungs, skin, and eyes. The elevated ACE levels are thought to be due to the granulomatous inflammation.

  • Other Likely Diagnoses

    • Lymphoma: Certain types of lymphoma, particularly those involving the lungs or mediastinum, can cause an increase in ACE levels.
    • Tuberculosis: This chronic bacterial infection can lead to granulomatous inflammation, which may result in elevated ACE levels.
    • Histoplasmosis: A fungal infection that can cause granulomatous disease, potentially leading to increased ACE levels.

  • Do Not Miss Diagnoses

    • Gaucher's Disease: A rare genetic disorder that can cause an increase in ACE levels due to the accumulation of glucocerebroside in cells.
    • Leishmaniasis: A parasitic infection that can lead to granulomatous inflammation and potentially elevated ACE levels.
    • Asbestosis: A lung disease caused by asbestos exposure, which may result in granulomatous changes and increased ACE levels.

  • Rare Diagnoses

    • Berylliosis: A rare lung disease caused by beryllium exposure, which can lead to granulomatous inflammation and elevated ACE levels.
    • Eosinophilic Granuloma: A rare condition characterized by the accumulation of eosinophils in tissues, potentially causing increased ACE levels.
    • Histiocytosis X: A group of rare diseases characterized by the accumulation of histiocytes in tissues, which may result in elevated ACE levels.

Each of these conditions has a different pathophysiology, but they can all lead to an increase in ACE levels due to the presence of granulomatous inflammation or other mechanisms. It's essential to consider the clinical context and perform further testing to determine the underlying cause of the elevated ACE levels.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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