At a Glance
Why Get Tested?
When to Get Tested?
When you have granulomas that create small bumps under the skin, a lingering cough, red watery eyes, and/or other symptoms suggestive of sarcoidosis; regularly when you have active sarcoidosis to monitor its course
A blood sample drawn from a vein in your arm
Test Preparation Needed?
The Test Sample
What is being tested?
This test measures the amount of angiotensin-converting enzyme (ACE) in the blood. ACE is an enzyme that helps regulate blood pressure. It assists in the conversion of angiotensin I (an inactive protein) to angiotensin II. Angiotensin II functions as a strong vasopressor; it causes arteries to contract, making them temporarily narrower and increasing the pressure of the blood flowing through them. ACE is produced throughout the body, but is especially concentrated in the lungs.
Increased amounts of ACE are sometimes secreted by cells found at the outside borders of granulomas. Granulomas are small tumor-like masses of immune and inflammatory cells and fibrous tissue that create bumps under the skin and throughout the body. They are a classic feature of sarcoidosis, a systemic disorder of unknown cause that often affects the lungs but may also affect many other body organs, including the eyes, skin, nerves, liver, and heart. ACE blood levels frequently increase when sarcoidosis-related granulomas develop.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
Ask a Laboratory Scientist
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Dugdale, D. (Updated 2009 November 15). ACE Levels. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003567.htm. Accessed July 2011.
Kamangar, N. and Shorr, A. (Updated 2011 April 14). Sarcoidosis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/301914-overview through http://emedicine.medscape.com. Accessed July 2011.
Grenache, D. and Roberts, W. (Updated 2010 October). Sarcoidosis. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Sarcoidosis.html?client_ID=LTD through http://www.arupconsult.com. Accessed July 2011.
(© 1995-2011). Unit Code 8285: Angiotensin Converting Enzyme, Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8285 through http://www.mayomedicallaboratories.com. Accessed July 2011.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 65-66.
Henry’s Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2007 Pg 257.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
Angiotensin Converting Enzyme. Marquette General Health System [On-line test catalog]. Available online at http://www.mgh.org/lab/CATALOG/TESTS/1685.HTM through http://www.mgh.org.
(2003). Angiotensin-converting Enzyme (ACE). LabCorp [On-line test information]. Available online at http://www.labcorp.com/datasets/labcorp/html/chapter/mono/sc002100.htm through http://www.labcorp.com.
Angiotensin-converting enzyme test. Hendrick Health System AccessMed Health Information Library [On-line information]. Available online at http://www.ehendrick.org/healthy/000080.htm through http://www.ehendrick.org.
Angiotensin Converting Enzyme. ARUP [On-line test information]. Available online at http://www.aruplab.com/guides/clt/tests/clt_al58.jsp#1142066 through http://www.aruplab.com.
Sarcoidosis. Hendrick Health System AccessMed Health Information Library [On-line information]. Available online at http://www.ehendrick.org/healthy/ through http://www.ehendrick.org.
Mayo Clinic Staff (2002 October 11). Sarcoidosis. MayoClinic.com [On-line information]. Available online through http://www.mayoclinic.com.
Milone, M. Updated (2002 March 14 Updated). ACE concentrations. MEDLINEplus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003567.htm.
Belfer, M. and Stevens, R. W. (1998 December). Sarcoidosis: A Primary Care Review. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/981200ap/belfer.html through http://www.aafp.org.
(2002 November, Updated). Sarcoidosis. Familydoctor.org [On-line information from AAFP]. Available online at http://familydoctor.org/handouts/320.html through http://familydoctor.org.
Stavrou, P. (1999). Ocular Sarcoidosis. Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary Harvard Medical School Boston, MA [On-line information]. Available online at http://www.uveitis.org/Enhanced/MD_info/md_sarcoidosis.htm through http://www.uveitis.org.
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 66-67.
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry, AACC Press, Washington, DC. Pp 116-117.
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 376-377.
Schriber, A. (2007 November 12, Updated). ACE levels. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003567.htm. Accessed on 1/30/08.
(© 2006-2008). Sarcoidosis - Angiotensin Converting Enzyme. ARUPConsult [On-line information]. Available online at http://www.arupconsult.com/Topics/PulmonaryDz/ACE.html through http://www.arupconsult.com. Accessed on 1/31/08.