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Epic Test Code LAB179 Angiotensin Converting Enzyme, Serum

Additional Codes

MML Code: ACE

 

NY State Approved

Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

Angiotensin Converting Enzyme, S

Method Name

Spectrophotometry (SP)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  180 days
  Ambient  24 hours


Necessary Information


The use of angiotensin converting enzyme (ACE)-inhibiting antihypertensive drugs will cause decreased ACE values. Patients taking ACE inhibitors, such as captopril and enalapril, will have extremely low or unmeasurable ACE activity. Indicate on the request form if the patient is on ACE inhibitors.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial


Bassett Healthcare Network Clinical Laboratories Note:

Blood Tube Draw Volume
Min 50% draw volume  

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Reference Values

≥18 years: 16-85 U/L

0-17 years: Angiotensin converting enzyme activity may be 20-50% higher in healthy children compared to healthy adults.

 

For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Report Available

1 to 3 days

Day(s) Performed

Monday through Friday

CPT Code Information

82164

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Useful For

Evaluation of patients with suspected sarcoidosis

Clinical Information

Angiotensin converting enzyme (ACE) is integral to the renin-angiotensin system (RAS), which maintains blood pressure by regulation of fluid volume and vascular tension. Its peptidase action on the decapeptide angiotensinogen I results in the hydrolysis of a terminal histidyl leucine dipeptide and the formation of the octapeptide angiotensin II, a potent vasoconstrictor that increases blood pressure.

 

ACE activity is increased in sarcoidosis, a systemic granulomatous disease that commonly affects the lungs. In sarcoidosis, ACE is thought to be produced by epithelioid cells and macrophages of the granuloma.

 

ACE activity reflects the severity of sarcoidosis: 68% positivity in those with stage I sarcoidosis, 86% in stage II sarcoidosis, and 91% in stage III sarcoidosis.

 

Other conditions such as Gaucher disease, leprosy, untreated hyperthyroidism, psoriasis, premature infants with respiratory distress syndrome, adults with amyloidosis, and histoplasmosis have been associated with increased serum ACE activity.

Interpretation

An elevation in the level of serum angiotensin converting enzyme (ACE), along with radiographic evidence of infiltrates or adenopathy and organ biopsies showing noncaseating epithelial granulomas is suggestive of a diagnosis of sarcoidosis.

 

Normal, healthy children and infants are known to have ACE activity levels greater than the adult reference interval.

Cautions

Spinal fluid angiotensin converting enzyme (ACE) activity to aid the diagnosis of neurosarcoidosis has been reported; however, there is insufficient evidence to support ACE being used for this purpose.

Specimen Retention Time

7 days

Disease States

  • Sarcoidosis

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Cardiovascular Test Request (T724)