CSF-ACE activity in probable CNS neurosarcoidosis
Tahmoush, A.J.; Amir, M.S.; Connor, W.W.; Farry, J.K.; Didato, S.; Ulhoa-Cintra, A.; Vasas, J.M.; Schwartzman, R.J.; Israel, H.L.; Patrick, H.
Sarcoidosis Vasculitis and Diffuse Lung Diseases Official Journal of Wasog 19(3): 191-197
2002
ISSN/ISBN: 1124-0490 PMID: 12405488 Document Number: 543946
To redefine the utility of CSF-ACE as a selective indicator of probable CNS neurosarcoidosis. The diagnosis of probable CNS neurosarcoidosis required: (a) biopsy evidence of systemic sarcoidosis, (b) cortical, brainstem, and/or spinal cord deficits, (c) enhancing lesions on brain and/or spinal cord MRI, and (d) exclusion of other etiologies which could account for the neurological deficits. Radioassay measurement of CSF-ACE activity was performed in 11 patients who met our criteria for probable CNS neurosarcoidosis and 207 control patients. The M +/- SD for CSF-ACE activity was significantly higher (p < 0.05) for the 11 probable CNS neurosarcoidosis patients (9.5 +/- 6.9 nmol/mL/min) than for the control patients (2.9 +/- 2.7 nmol/mL/min). The optimal CSF-ACE activity discriminator value was 8 nmol/mL/min. At this value, the sensitivity and specificity of CSF-ACE activity was 55% and 94%, respectively. CSF-ACE activity is a useful biochemical marker of probable CNS neurosarcoidosis when brain and/or spinal cord MRI show diffuse enhancing lesions.