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ACE levels is a blood test that measures the amount of angiotensin-converting enzyme (ACE).

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

After the blood has been drawn, it goes to a laboratory to be evaluated.

You may have to restrict food and fluids for up to 12 hours before the test. People taking steroid therapy should talk to their health care providers, because steroids can decrease ACE levels.

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

ACE levels can be used in the evaluation of sarcoidosis and some other diseases. People with sarcoidosis may have their ACE levels tested regularly to check the severity of the disease and to monitor the response to therapy. This test also helps confirm Gaucher's disease and leprosy.

Normal values vary based on your age and the test method used. Typically, adults have ACE levels less than 40 micrograms/L.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

This test is often used to help diagnose sarcoidosis, a condition in which ACE levels are increased 75% of the time. Elevated ACE levels may also be seen in several other disorders, including:

• Active histoplasmosis
• Alcoholic cirrhosis
• Amyloidosis
• Asbestosis
• Berylliosis
• Diabetes
• Gaucher's disease
• Hodgkin's disease
• Hyperthyroidism
• Idiopathic pulmonary fibrosis
• Leprosy
• Myeloma
• Primary biliary cirrhosis
• Pulmonary embolism
• Scleroderma
• Silicosis
• Tuberculosis

A decrease in ACE levels may indicate:

• Steroid therapy (usually prednisone)
• Response to therapy for sarcoidosis

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 light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Serum angiotensin-converting enzyme; SACE

Ferri FF. Ferri’s Clinical Advisor: Instant Diagnosis and Treatment. 2005 ed. St. Louis, Mo: Mosby; 2005:1257.

Updated by: Andrew Schriber, M.D., F.C.C.P., Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network.