Sarcoidosis laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
===Angiotensin-converting enzyme=== | ===[[Angiotensin-converting enzyme]]=== | ||
[[ACE]] is produced in [[epithelioid cells]] of [[granuloma]]s, therefor [[ACE]] levels may show the burden of [[sarcoidosis]] [[granuloma]]s in the body<ref>Shefield EA: Pathology of sarcoidosis. Clin Chest Med 18(4):741–754, 1997.</ref>. [[ACE]] has been proposed as a diagnostic test for [[sarcoidosis]], but the sensivity and specifity of an elevated [[ACE]] level is '''not''' enough to diagnose and/or rule out [[sarcoidosis]]<ref>Bunting PS, Szalai JP, Katic M: Diagnostic aspects of angiotensin converting enzyme in pulmonary sarcoidosis. Clin Biochem 20(3): 213–219, 1987.</ref>. | [[ACE]] is produced in [[epithelioid cells]] of [[granuloma]]s, therefor [[ACE]] levels may show the burden of [[sarcoidosis]] [[granuloma]]s in the body<ref>Shefield EA: Pathology of sarcoidosis. Clin Chest Med 18(4):741–754, 1997.</ref>. [[ACE]] has been proposed as a diagnostic test for [[sarcoidosis]], but the sensivity and specifity of an elevated [[ACE]] level is '''not''' enough to diagnose and/or rule out [[sarcoidosis]]<ref>Bunting PS, Szalai JP, Katic M: Diagnostic aspects of angiotensin converting enzyme in pulmonary sarcoidosis. Clin Biochem 20(3): 213–219, 1987.</ref>. | ||
* Sensivity: 77% | * Sensivity: 77% | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.
Overview
Although serum ACE level has been proposed as a diagnostic test for sarcoidosis, the sensivity and specifity of an elevated ACE level, is not enough to diagnose and/or rule out sarcoidosis.
Laboratory Findings
Angiotensin-converting enzyme
ACE is produced in epithelioid cells of granulomas, therefor ACE levels may show the burden of sarcoidosis granulomas in the body[1]. ACE has been proposed as a diagnostic test for sarcoidosis, but the sensivity and specifity of an elevated ACE level is not enough to diagnose and/or rule out sarcoidosis[2].
- Sensivity: 77%
- Specifity: 93%
- Serum ACE level greater than two times the upper limit of normal are rarely seen in other disease[3][4].
Serum chitotriosidase
has been shown to be elevated in sarcoidosis and is associated with worse prognosis[5][6].
Hypercalcemia
Hypercalcemia and/or hypercalciuria is seen in up to 30% of patients diagnosed with sarcoidosis[7].Levels of 1,25-dihydroxyvitamin D may be elevated despite low levels of 25 hydroxyvitamin D[8].
References
- ↑ Shefield EA: Pathology of sarcoidosis. Clin Chest Med 18(4):741–754, 1997.
- ↑ Bunting PS, Szalai JP, Katic M: Diagnostic aspects of angiotensin converting enzyme in pulmonary sarcoidosis. Clin Biochem 20(3): 213–219, 1987.
- ↑ Lieberman J, Nosal A, Schlessner A, Sastre-Foken A: Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis 120(2):329–335, 1979.
- ↑ Silverstein E, Schussler GC, Friedland J: Elevated serum angiotensinconverting enzyme in hyperthyroidism. Am J Med 75(2):233–236, 1983.
- ↑ Bargagli E, Bennett D, Maggiorelli C, et al: Human chitotriosidase: a sensitive biomarker of sarcoidosis. J Clin Immunol 33(1):264–270, 2013.
- ↑ Bargagli E, Bianchi N, Margollicci M, et al: Chitotriosidase and soluble IL-2 receptor: comparison of two markers of sarcoidosis severity. Scand J Clin Lab Invest 68(6):479–483, 2008.
- ↑ Rizzato G, Fraioli P, Montemurro L: Nephrolithiasis as a presenting feature of chronic sarcoidosis. Thorax 50(5):555–559, 1995.
- ↑ Baughman RP, Janovcik J, Ray M, et al: Calcium and vitamin D metabolism in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 30(2):113–120, 2013.