Sace blood test clinical significance
Pro Research Analysisby 
Searched over 200M research papers
Serum Angiotensin-Converting Enzyme (SACE) Blood Test: Clinical Significance in Sarcoidosis and Other Diseases
SACE as a Diagnostic Marker for Sarcoidosis
The SACE blood test is widely recognized for its role in diagnosing sarcoidosis, a granulomatous disease that often affects the lungs and lymph nodes. Elevated SACE levels are found in a significant proportion of sarcoidosis patients, with studies reporting sensitivities ranging from 55% to over 90% depending on disease activity and patient selection 13479. SACE levels are typically much higher in sarcoidosis patients compared to healthy controls and those with other lung diseases 3457. The test shows good specificity, often above 80%, and is particularly useful when combined with other clinical findings 347.
SACE and Disease Activity Monitoring
SACE levels correlate with disease activity in sarcoidosis. Higher SACE values are seen in patients with active disease, especially those with systemic or multi-organ involvement 13478. Serial measurements of SACE can help monitor the course of the disease and the effectiveness of treatments such as corticosteroids, as SACE levels tend to decrease with successful therapy 1458. However, SACE is not always able to fully distinguish between active and inactive disease, as some patients with dormant disease may still have elevated levels 14.
SACE in Differential Diagnosis
While SACE is most commonly elevated in sarcoidosis, it can also be increased in other granulomatous diseases such as silicosis, asbestosis, Gaucher’s disease, and leprosy, and to a lesser extent in conditions like hyperthyroidism and cholestasis 2459. False positives can occur, particularly in these diseases, but the rate is generally low in other chronic lung conditions 459. Conversely, SACE levels are often decreased in certain blood cancers (like leukemia and multiple myeloma) and vascular diseases, which can help differentiate sarcoidosis from these conditions 26.
SACE Test Limitations and Considerations
The SACE test is not perfect. Normal SACE levels do not rule out sarcoidosis, especially in early or inactive cases 49. The test’s sensitivity and specificity can be influenced by the prevalence of other diseases in the population, the method of measurement, and patient factors such as age and sex 24. Additionally, SACE levels may not correlate with other markers of inflammation, such as erythrocyte sedimentation rate (ESR) .
SACE in Other Clinical Contexts
SACE measurement can also be useful in evaluating patients with unexplained lymphadenopathy or suspected granulomatous disease, helping to distinguish sarcoidosis from malignancies and other causes 610. In rare cases, SACE can aid in the assessment of sarcoid-like conditions affecting specific organs, such as the eyes (dacryoadenitis), though its predictive value is limited by overlap with other diseases .
Conclusion
The SACE blood test is a valuable tool for diagnosing and monitoring sarcoidosis, especially when interpreted alongside clinical findings and other investigations. It is most useful for identifying active, systemic disease and tracking response to therapy. However, elevated SACE is not exclusive to sarcoidosis, and normal levels do not exclude the disease. Clinicians should use SACE results as part of a broader diagnostic and management strategy.
Sources and full results
Most relevant research papers on this topic