Clinical features and serum ACE activity of 42 patients with sarcoidosis were analyzed and the following results were obtained. The patients ages ranged from 12 to 73 years old, with a median age of 39. Peaks in the age distribution were from 20 to 30 in males and 40 to 50 in females. 1) A scalene node biopsy in 24 out of 32 cases (75%) yielded a diagnosis of sarcoidosis, whereas the Kveim test was positive in only 2 out of 10 patients (20%). A negative PPD skin test was observed in 65% of the patients at their initial visit. Sixty-two percentage of patients who were sensitive to tuberculin before the onset of sarcoidosis became insensitive after acquisition of this illness. 2) A decreased number of peripheral lymphocytes and T-lymphocytes was found in 31% and 52% of the patients respectively, and an increased number of B-lymphocytes in 24% of the patients was observed. 3) The period for abnormal chest shadows to disappear ranged from 1 to 36 months, with a median of 10 months. Three cases whose abnormal chest shadow continued for more than 5 years were all female. 4) Serum ACE activity was significantly elevated in 19 patients with sarcoidosis compared with 15 normal subjects. Active sarcoidosis patients had significantly higher ACE activity than inactive patients (p<0.005). Serum ACE activity in patients with both bilateral hilar adenopathy and lung parenchymal involvement was significantly higher than in patients with bilateral hilar adenopathy alone (p< 0.05). 5) The patients receiving steroids had significantly lower ACE activity than patients receiving no steroids (p<0.05). These findings indicate that measurement of serum ACE activity in patients with sarcoidosis is one of the most useful indicators for the therapy of this illness.
Angiotensin converting enzyme activity