Serum angiotensin converting enzyme in Sjogren's syndrome--a case report and study of 21 further cases.

We report the case of an elderly woman with primary Sjogren's syndrome and abnormal liver function tests indicative of primary biliary cirrhosis. She was found to have a raised serum angiotensin converting enzyme activity. We proceeded to study 21 further cases of Sjogren's syndrome to discover whether raised levels of this enzyme were a feature of Sjogren's syndrome. None of them had any features to suggested associated primary biliary cirrhosis. The cases included 12 with associated rheumatoid arthritis, two with systemic sclerosis, three with systemic lupus erythematosus and four with primary Sjogren's syndrome. In only two of these 21 patients was a raised serum angiotensin converting enzyme obtained, the elevation being modest. We conclude that a raised activity of the enzyme is not usually associated with primary or secondary Sjogren's syndrome, and that discovery of such an abnormality should prompt a search for an associated condition.