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August 1997

Serum Angiotensin-Converting Enzyme in Multiple Sclerosis

Author Affiliations

From the Departments of Neurology (Dr Constantinescu), Radiology (Neuroradiology) (Dr Grossman and Ms Mannon), and Pathology and Laboratory Medicine (Dr Goodman), University of Pennsylvania, Philadelphia, and the Mellen Center for Multiple Sclerosis Treatment and Research, The Cleveland Clinic Foundation, Cleveland, Ohio (Dr Cohen).

Arch Neurol. 1997;54(8):1012-1015. doi:10.1001/archneur.1997.00550200068012

Objective:  To determine the extent and significance of serum angiotensin-converting enzyme (ACE) elevation in multiple sclerosis (MS) and the correlation between serum ACE activity and clinical and magnetic resonance imaging (MRI) indicators of disease activity.

Design:  A retrospective cross-sectional study of 45 consecutive patients with clinically definite MS and a longitudinal study of 30 additional patients with clinically definite MS involved in a long-term study of neurologic function and MRI in MS.

Setting:  Comprehensive MS center of a tertiary care university hospital.

Subjects:  A total of 75 patients with clinically definite MS and 31 healthy controls.

Methods:  Serum ACE activity was measured using a spectrophotometric assay and correlated with clinical indicators of disease activity and with total cerebral MS lesion volume measured by MRI.

Results:  An elevated ACE activity was found in 17 (23%) of 75 patients with MS as compared with 2 (6%) of 31 healthy controls. Changes in serum ACE activity correlated with changes in total plaque volume on MRI.

Conclusions:  Serum ACE activity may be an indicator of disease activity in longitudinal analysis. Also, elevated ACE activity in a patient with otherwise typical MS need not raise suspicions of alternative diagnoses.

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