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===Serum [[chitotriosidase]]===
===Serum [[chitotriosidase]]===
Has been shown to be elevated in [[sarcoidosis]] and is associated with worse prognosis<ref>Bargagli E, Bennett D, Maggiorelli C, et al: Human chitotriosidase: a
Has been shown to be elevated in [[sarcoidosis]] and is associated with worse prognosis<ref>Bargagli E, Bennett D, Maggiorelli C, et al: Human chitotriosidase: a
sensitive biomarker of sarcoidosis. J Clin Immunol 33(1):264–270, 2013.</ref><ref>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.</ref>.
sensitive biomarker of sarcoidosis. J Clin Immunol 33(1):264–270, 2013.</ref><ref name="inter">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.</ref>.
===[[Soluble interleukin-2 receptor]]===
===[[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<ref>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.</ref><ref>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.</ref>
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<ref name="inter">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.</ref><ref>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.</ref>.
===[[Hypercalcemia]]===
===[[Hypercalcemia]]===
[[Hypercalcemia]] and/or [[hypercalciuria]] is seen in up to 30% of patients diagnosed with [[sarcoidosis]]<ref>Rizzato G, Fraioli P, Montemurro L: Nephrolithiasis as a presenting feature of chronic sarcoidosis. Thorax 50(5):555–559, 1995.</ref>. Levels of [[1,25-dihydroxyvitamin D]] may be elevated despite low levels of [[25 hydroxyvitamin D]]<ref>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.</ref>.
[[Hypercalcemia]] and/or [[hypercalciuria]] is seen in up to 30% of patients diagnosed with [[sarcoidosis]]<ref>Rizzato G, Fraioli P, Montemurro L: Nephrolithiasis as a presenting feature of chronic sarcoidosis. Thorax 50(5):555–559, 1995.</ref>. Levels of [[1,25-dihydroxyvitamin D]] may be elevated despite low levels of [[25 hydroxyvitamin D]]<ref>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.</ref>.

Latest revision as of 21:23, 10 May 2018

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


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

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

  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.

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