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What is Angiotensin Converting Enzyme (ACE) test? 

Angiotensin-converting enzyme (ACE) plays an important role in the regulation of blood pressure. ACE levels are usually high in sarcoidosis patients. Sarcoidosis is an inflammatory disease marked by the formation of granulomas under the skin. These granulomas appear as small tiny bumps, along with other symptoms such as watering of the eyes and persistent coughing.

An ACE test is done to measure the level of Angiotensin-converting enzyme in the bloodstream. This test mainly helps check for the presence of sarcoidosis in patients; however, abnormal ACE may also be an indication of other diseases like diabetes mellitus and hypothyroidism.

  1. Why is an Angiotensin-Converting Enzyme (ACE) test performed?
  2. How do you prepare for an Angiotensin-Converting Enzyme (ACE) test?
  3. How is an Angiotensin-Converting Enzyme (ACE) test performed?
  4. Angiotensin-Converting Enzyme (ACE) test results and normal range

Doctors order this test if a patient displays symptoms of sarcoidosis. Patients with sarcoidosis develop small masses of immune cells called granulomas in various parts of body. The masses are most commonly seen in the lungs and lead to various health issues. 

Symptoms of sarcoidosis include:

Your healthcare provider may instruct you to avoid eating or drinking for up to 12 hours before the test. In case you are on steroid medication, you must discuss this with your doctor because steroids can affect the results of this test. Apart from this, you must also inform your doctor about any other medicines, including herbs, vitamins or supplements that you are taking. He/she may ask you to stop taking certain drugs. Do not stop taking any prescribed medicine on your own.

(Health checkup app)

In order to conduct the test, a doctor or laboratory technician will take a small sample of your blood from a vein in your arm. This is done using the following steps:

  • The healthcare provider will wrap an elastic band around your upper arm to slow the flow of blood. This will make the veins present below the band to swell up so that a needle can be easily inserted
  • The injection site will then be cleaned with the help of alcohol and blood will be withdrawn using a sterile needle. You may feel no pain or just a quick sting or pinch from the needle. Sometimes, more than one needle insertion may be required 
  • Once enough blood is collected, the elastic band will be removed from your arm

A cotton ball will be placed over the needle site as the needle is removed. Mild pressure will be applied to the site for a few minutes and a bandage may be put over the area later.

Normal results:

The normal values of ACE depend on a person’s age. For adults, ACE levels should be less than 40 micrograms/litre.

However, this range usually varies a bit from one laboratory to another.

Abnormal results: 

Higher than normal ACE levels can be a sign of sarcoidosis. People in the age group of 20-40 years are at a higher risk of sarcoidosis. If your doctor confirms that you have sarcoidosis, then ACE tests may need to be done at regular intervals in order to monitor your condition.

High ACE levels can also indicate other diseases or disorders such as:

Lower than normal levels of ACE indicate:

  • Chronic liver disease
  • Kidney failure
  • Anorexia nervosa (an eating disorder)
  • Hypothyroidism

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Carty RP, Pincus MR, Sarafraz-Yazdi E. Henry’s Clinical Diagnosis and Management by Laboratory Methods. Clinical enzymology. 23rd ed. St Louis, MO: Elsevier. Chap 20.
  2. Chernecky CC, Berger BJ. Laboratory Tests and Diagnostic Procedures. Angiotensin-converting enzyme (ACE)- blood. 6th ed. St Louis, MO: Elsevier Saunders. Pp: 138-139.
  3. MedlinePlus Medical Encyclopedia: US National Library of Medicine; ACE blood test
  4. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Angiotensin Converting Enzyme (Blood)
  5. Glaucestershire Hospitals. NHS Foundation Trust. National Health Service. U.K. Angiotensin Converting Enzyme (ACE)
  6. UCSF health: University of California [internet]; ACE Levels

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