Angiotensin-Converting Enzyme Activity and Steroid Therapy in Sarcoidosis

Abstract

To the Editor. —It is well known that measuring serum angiotensin-converting enzyme (ACE) levels is a useful tool to regulate therapy in sarcoidosis and to confirm the diagnosis. 1 Most recently, Thompson et al 2 demonstrated that a single dose of 75 mg of prednisolone failed to alter serum ACE concentrations within a 24-hour period, and they suggested that two to four weeks of steroid therapy may be required before ACE concentrations fell. This decline in ACE concentration would be secondary to a reduction in the massive granulomas rather than a direct biochemical/receptor influence on ACE biosynthesis. Since active and continuous biosynthesis of ACE is carried out in granulomatous lesions of sarcoidosis, 3 it is not considered that ACE concentration actively produced by sarcoid granulomas may alter before or after only a single dose of prednisolone. For a better understanding of the response of serum ACE concentrations for steroid therapy,