ACE blood testSerum angiotensin-converting enzyme; SACE
The ACE test measures the level of angiotensin-converting enzyme (ACE) in the blood.
How the Test is Performed
A blood sample is needed.
How to Prepare for the Test
Follow your health care provider's instructions for not eating or drinking anything for up to 12 hours before the test. If you are on steroid medicine, ask your provider if you need to stop the medicine before the test, because steroids can decrease ACE levels. Do not stop any medicine before talking to your provider.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. These soon go away.
Why the Test is Performed
This test is commonly ordered to help diagnose and monitor a disorder called sarcoidosis. People with sarcoidosis may have their ACE level tested regularly to check how severe the disease is and how well treatment is working.
Normal values vary based on your age and the test method used. Adults have an ACE level less than 40 micrograms/L.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Higher than normal ACE level may be a sign of sarcoidosis. ACE level rises or falls as sarcoidosis worsens or improves.
A higher than normal ACE level may also be seen in several other diseases and disorders, including:
- Cancer of the lymph tissue (Hodgkin disease)
- Liver swelling and inflammation (hepatitis) due to alcohol use
- Lung disease such as asthma, cancer, chronic obstructive pulmonary disease, or tuberculosis
- Kidney disorder called nephrotic syndrome
- Multiple sclerosis
- Overactive thyroid (hyperthyroidism)
Lower than normal ACE level may indicate:
- Chronic liver disease
- Eating disorder called anorexia nervosa
- Steroid therapy (usually prednisone)
- Therapy for sarcoidosis
- Underactive thyroid (hypothyroidism)
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
The risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Pincus MR, Abraham NZ, Carty RP. Clinical enzymology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 20.
Iannuzzi M. Sarcoidosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 95.
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Review Date: 11/1/2013
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.