Angiotensin-converting Enzyme as a Predictor of Extrathoracic Involvement of Sarcoidosis

Angiotensin-converting Enzyme as a Predictor of Extrathoracic Involvement of Sarcoidosis

Authors

  • Zehra Yasar Abant Izzet Baysal University School of Medicine
  • Mehmet Akif Özgül
  • Erdoğan Cetinkaya
  • Aysel Kargi
  • Şule Gül
  • Fahrettin Talay
  • Elif Tanriverdi
  • H. Erhan Dincer

Keywords:

Sarcoidosis, ACE, extrathoracic involvement

Abstract

Background: Sarcoidosis is a multisystem disease, with extrathoracic involvement occurring in 25–50% of patients. Multi-organ involvement is often associated with a more chronic and severe course. The value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in diagnosing extrathoracic involvement in sarcoidosis has been demonstrated; however, because of the radiation dose and high cost, indications for its use must be well defined. Angiotensin-converting enzyme (ACE) is produced by active granuloma cells; thus, serum ACE (sACE) levels may reflect the total granuloma load. Objectives: In this retrospective study, we evaluated the diagnostic value of sACE in the detection of extrathoracic involvement in sarcoidosis. Methods: 43 patients with biopsy-proven sarcoidosis underwent FDG-PET/CT during the initial workup. Positive findings were classified as thoracic and/or extrathoracic. The diagnostic value of sACE was estimated using sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs). Results: Of the 43 patients studied, 17 (39.7%) had extrathoracic involvement. In this group, sACE values were higher than in patients without extrathoracic involvement (331 vs. 150, p=0.002) and correlated positively with extrathoracic involvement (R:0.532 p=0.02). Receiver operator characteristic curve analysis revealed an AUC of 0.816 [95% confidence interval: 0.669–0.963, p=0.002], 70.6% sensitivity and 80% specificity at the sACE cut-off value. Conclusions: In sarcoidosis, extrathoracic involvement may be life threatening or indicative of poor outcome. sACE levels are easily determined and may predict extrathoracic involvement. In patients with sarcoidosis, sACE levels can be used to better define those who would benefit from FDG-PET/CT examination to detect extrathoracic involvement. (Sarcoidosis Vasc Diffuse Lung Dis 2015; 32: 318-324)

Author Biography

Zehra Yasar, Abant Izzet Baysal University School of Medicine

Department of Chest Diseases

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Published

18-01-2016

Issue

Section

Original Articles: Clinical Research

How to Cite

1.
Yasar Z, Özgül MA, Cetinkaya E, Kargi A, Gül Şule, Talay F, et al. Angiotensin-converting Enzyme as a Predictor of Extrathoracic Involvement of Sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2016 Jan. 18 [cited 2025 May 20];32(4):318-24. Available from: https://mattioli1885journals.com/index.php/sarcoidosis/article/view/4117