Serum angiotensin-converting enzyme activity. Its use in the evaluation and management of hypercalcemia associated with sarcoidosis

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Abstract
Serum angiotensin-converting enzyme (SACE) was measured in 14 patients (8 women and 6 men) with sarcoidosis and hypercalcemia; 13 patients were treated with prednisone. Twelve achieved normal or nearly normal serum Ca values. Two patients had coexistent hyperparathyroidism; 7 of 8 patients with serial SACE measurements exhibited parallel falls in SACE and serum Ca levels. Eleven patients were successfully treated with alternate-day prednisone regimens. Serial SACE measurements evidently are useful in the evaluation and management of sarcoidosis with hypercalcemia. In patients with sarcoidosis, the reduction of SACE levels during glucocorticoid treatment may be due to a suppression of granuloma formation. Concomitant falls in serum Ca level suggest an important role of the grnauloma or its cellular precursors in vitamin D metabolism.