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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Sarcoidosis laboratory findings

Introduction

Overview

Overview

Although serum ACE level has been proposed as a diagnostic test for sarcoidosis, the sensivity and specifity of an elevated ACE level, is not enough to diagnose and/or rule out sarcoidosis.

Laboratory Findings

Laboratory Findings

Angiotensin-converting enzyme

ACE is produced in epithelioid cells of granulomas, therefor ACE levels may show the burden of sarcoidosis granulomas in the body[1]. ACE has been proposed as a diagnostic test for sarcoidosis, but the sensivity and specifity of an elevated ACE level is not enough to diagnose and/or rule out sarcoidosis[2].

  • Sensivity: 77%
  • Specifity: 93%
  • Serum ACE levels greater than two times the upper limit of normal are rarely seen in other disease[3][4].

Serum chitotriosidase

Has been shown to be elevated in sarcoidosis and is associated with worse prognosis[5][6].

Soluble interleukin-2 receptor

The soluble interleukin-2 receptor is a marker of T-cell activation and found to be elevated in sarcoidosis patients and can be as an effective marker of disease activity[6][7].

Hypercalcemia

Hypercalcemia and/or hypercalciuria is seen in up to 30% of patients diagnosed with sarcoidosis[8]. Levels of 1,25-dihydroxyvitamin D may be elevated despite low levels of 25 hydroxyvitamin D[9].

Kveim test

In this test a suspension of splenic cells from patients with sarcoidosis (kveim-siltzbach reagent), is injected intradermally to evoke sarcoid granulomatous response over 3 weeks. It is a research tool rather than a diagnostic method.

References

References

  1. ↑ Shefield EA: Pathology of sarcoidosis. Clin Chest Med 18(4):741–754, 1997.
  2. ↑ Bunting PS, Szalai JP, Katic M: Diagnostic aspects of angiotensin converting enzyme in pulmonary sarcoidosis. Clin Biochem 20(3): 213–219, 1987.
  3. ↑ Lieberman J, Nosal A, Schlessner A, Sastre-Foken A: Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis 120(2):329–335, 1979.
  4. ↑ Silverstein E, Schussler GC, Friedland J: Elevated serum angiotensinconverting enzyme in hyperthyroidism. Am J Med 75(2):233–236, 1983.
  5. ↑ Bargagli E, Bennett D, Maggiorelli C, et al: Human chitotriosidase: a sensitive biomarker of sarcoidosis. J Clin Immunol 33(1):264–270, 2013.
  6. ↑ 6.0 6.1 Bargagli E, Bianchi N, Margollicci M, et al: Chitotriosidase and soluble IL-2 receptor: comparison of two markers of sarcoidosis severity. Scand J Clin Lab Invest 68(6):479–483, 2008.
  7. ↑ Grutters JC, Fellrath JM, Mulder L, et al: Serum soluble interleukin-2 receptor measurement in patients with sarcoidosis: a clinical evaluation. Chest 124(1):186–195, 2003.
  8. ↑ Rizzato G, Fraioli P, Montemurro L: Nephrolithiasis as a presenting feature of chronic sarcoidosis. Thorax 50(5):555–559, 1995.
  9. ↑ Baughman RP, Janovcik J, Ray M, et al: Calcium and vitamin D metabolism in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 30(2):113–120, 2013.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.