Rømer F K
Acta Med Scand. 1980;208(6):437-43.
Serum angiotensin-converting enzyme (SACE) was measured in 56 patients with sarcoidosis within three months after diagnosis. Serial analyses were performed in 42 patients, who were followed for two months to one year. SACE was elevated in 49 (70%) of the patients at some time during the period of observation. Erythema nodosum (EN) was present in 14 patients. Only one out of seven had elevated SACE during EN, but four months later SACE was elevated in all 14. In this group there was a negative correlation between SACE and S-lysozyme. Among 42 patients without EN the frequency of SACE elevation was rather constant, about 60%. In half of the patients SACE was normal at first examination, and subsequent elevation was observed in 19%. SACE and S-lysozyme were positively correlated. Enzyme activity was independent of mode of presentation, but a non-significant trend toward higher SACE in patients with pulmonary involvement was observed, and changes in SACE were roughly correlated to roentgenological changes. Among healthy controls, significantly higher SACE levels were found in children up to 17 years of age (reference interval 21.2-42.2 U/ml) than in adults aged 18-65 years (12.0-36.8 U/ml). The observations on patients with sarcoidosis demonstrate that a unique pattern of SACE occurs in those with EN, different from that of patients without EN. The findings support the view that EN is a hallmark of acute-onset sarcoidosis. The value of serial SACE analyses is emphasized.
在56例结节病患者确诊后三个月内测定了血清血管紧张素转换酶（SACE）。对42例患者进行了连续分析，随访时间为两个月至一年。在观察期间的某个时间，49例（70%）患者的SACE升高。14例患者出现结节性红斑（EN）。在EN期间，7例中只有1例SACE升高，但四个月后所有14例患者的SACE均升高。在该组中，SACE与S-溶菌酶呈负相关。在42例无EN的患者中，SACE升高的频率相当稳定，约为60%。一半患者初次检查时SACE正常，随后有19%出现升高。SACE与S-溶菌酶呈正相关。酶活性与表现方式无关，但观察到肺部受累患者的SACE有升高的非显著趋势，且SACE的变化与放射学变化大致相关。在健康对照中，17岁以下儿童（参考区间21.2 - 42.2 U/ml）的SACE水平显著高于18 - 65岁成年人（12.0 - 36.8 U/ml）。对结节病患者的观察表明，有EN的患者出现了独特的SACE模式，与无EN的患者不同。这些发现支持了EN是急性起病结节病标志的观点。强调了连续SACE分析的价值。
