Kocaeli Med J. 2019; 8(3): 132-141 | DOI: 10.5505/ktd.2019.82474

The Role of Serum Angiotensin Converting Enzyme for Predicting Pulmonary Parenchymal and Extrapulmonary Involvement of Sarcoidosis

Onur Yazýcý, Fisun Karadað, Emel Ceylan, Þule Taþ Gülen, Hatice Arzu Uçar, Mehmet Polatlý
Aydýn Adnan Menderes University Faculty of Medicine, Department of Chest Diseases, Aydýn, Turkey

INTRODUCTION: The clinical characteristics and course of sarcoidosis vary according to the age of onset, duration, stage, and extent of the disease. Biomarkers that can predict clinical characteristics and course will provide convenience in disease management. We aimed to determine relationships of hematologic and biochemical parameters with the stage and extent of the disease.
METHODS: The charts of sarcoidosis patients between 2013 and 2018 were retrospectively investigated. Demographic data, clinical findings at the time of diagnosis, stage, and extrapulmonary involvement were recorded together with complete blood count, erythrocyte sedimentation rate, serum C-reactive protein, calcium, and angiotensin converting enzyme (ACE) levels. Patients were classified according to the presence of pulmonary parenchymal and extrapulmonary involvement. Stage-1 patients with no pulmonary parenchymal involvement were in Group 1, and stage-2 and stage-3 patients with pulmonary parenchymal involvement in Group 2.
RESULTS: Of 121 sarcoidosis patients, 30 (24.8%) were male, 91 (75.2%) female. The average age was 50.71±11.76 years. 59 (48.8%) patients were in Group 1, and 62 (51.2%) in Group 2. Pulmonary involvement was present only in 71 (58.7%) patients. Extrapulmonary and pulmonary involvement was present in 50 (41.3%) patients. Most common extrapulmonary involvement was erythema nodosum (15.7%). Serum ACE level was higher in Group 2 than Group 1 (p=0.027) and in cases with pulmonary and extrapulmonary involvement both than those with pulmonary involvement only (p=0.045). No significant deviations were found between the groups regarding other laboratory parameters.
DISCUSSION AND CONCLUSION: The serum ACE level may be useful in showing both the pulmonary parenchymal and extrapulmonary involvements.

Keywords: Sarcoidosis, angiotensin converting enzyme, pulmonary involvement, extrapulmonary involvement.

---

Sarkoidozda Pulmoner Parankimal ve Ekstrapulmoner Tulumu Belirlemede Serum Anjiyotensin Konverting Enzimin Rolü

Onur Yazýcý, Fisun Karadað, Emel Ceylan, Þule Taþ Gülen, Hatice Arzu Uçar, Mehmet Polatlý
Aydýn Adnan Menderes Üniversitesi Týp Fakültesi, Göðüs Hastalýklarý Ana Bilim Dalý, Aydýn, Türkiye

GÝRÝÞ ve AMAÇ: Sarkoidoz günümüzde halen etiyolojisi bilinmeyen bir hastalýktýr. Klinik tablo ve seyir hastalýðýn baþlangýç yaþýna, süresine, evresine ve yaygýnlýðýna baðlý olarak deðiþmektedir. Klinik tabloyu ve seyri öngörebilecek biyomarkerlarýn kullanýlmasý hastalýðýn yönetiminde kolaylýk saðlayacaktýr. Çalýþmamýzda hematolojik ve biyokimyasal parametrelerle hastalýðýn evre ve yaygýnlýðý arasýndaki iliþkiyi belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: 2013-2018 yýllarý arasýnda kliniðimizde sarkoidoz tanýsý konulan hastalarýn dosyalarý retrospektif olarak incelendi. Hastalarýn demografik verileri, taný sýrasýndaki klinik bulgularý, evreleri, ekstrapulmoner tutulum olup olmadýðý ve hemogram, eritrosit sedimentasyon hýzý (ESR), C reaktif protein (CRP), serum kalsiyum (Ca) ve anjiotensin konverting enzim (ACE) düzeylerini içeren laboratuvar parametreleri kaydedildi. Hastalar akciðer parankim tutulumu ve ekstrapulmoner tutulumu olup olmamasýna göre sýnýflandýrýldý. Akciðer parankim tutulumu olmayan evre 1 hastalar grup 1 ve akciðer parankim tutulumu olan evre 2 ve 3 hastalar grup 2 olarak sýnýflandýrýldý.
BULGULAR: Belirlenen tarihler arasýnda 121 sarkoidoz hastasýnýn verilerine ulaþýldý. Hastalarýn 30 (%24.8)’u erkek, 91 (%75.2)’i kadýn ve yaþ ortalamasý 50.71±11.76 idi. Grup 1’de 59 (%48,8) ve grup 2’de 62 (%51,2) olgu vardý. Hastalarýn 71 (%58,9)’de sadece akciðer tutulumu varken 50 (%41.3)’sinde akciðer ve akciðer dýþý organ tutulumu birlikte vardý. Akciðer dýþý organ tutulumu en sýk eritema nodozum (EN)’du (%15,7). Grup 2 olgularda serum ACE deðeri grup 1’den daha yüksekti (p =0,027). Akciðer ve akciðer dýþý tutulumu olan olgularda serum ACE düzeyi akciðer dýþý tutulum olmayanlara göre daha yüksekti (p =0,045). Bakýlan diðer laboratuvar parametreleri gruplar arasýnda farklý deðildi.
TARTIÞMA ve SONUÇ: Serum ACE düzeyi akciðer parankim tutulumunu ve ekstrapulmoner tutulumu göstermede faydalý olabilir.

Anahtar Kelimeler: Sarkoidoz, anjiotensin konverting enzim, pulmoner parankimal tutulum, ekstrapulmoner tutulum

---

CITE