The value of combined serum angiotensin-converting enzyme and gallium scan in diagnosing ocular sarcoidosis
The value of combined serum angiotensin-converting enzyme and gallium scan in diagnosing ocular sarcoidosis
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DOI：
10.1016/s0161-6420(95)30763-4
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发表时间：
1995-12-01
期刊：
影响因子：
13.7
通讯作者：
Foster, CS
中科院分区：
文献类型：
--
作者：
Power, WJ;Neves, RA;Foster, CS
目的：评价血清血管紧张素转换酶（ACE）活性和全身镓（67）GA）扫描联合检测在诊断眼部结节病但胸片正常或可疑患者中的作用。方法：血清ACE水平和全身（67）GA扫描作为22例活动性眼部炎症患者初始检查的一部分，并最终进行活检。确诊结节病（结节性葡萄膜炎组）。第二组包括70例活动性葡萄膜炎患者，其中结节病也被认为是诊断的可能性，所有70例患者最终都得到了结节病以外的明确诊断在这一组中的所有患者还进行了血清ACE和全身（67）GA扫描，作为其初始调查的一部分。所有的结节病葡萄膜炎患者要么ACE水平升高，要么扫描异常。在22名患者中，16名患者的两项检查结果均异常，在非结节病葡萄膜炎组中没有患者的两项检查结果均异常。ACE升高诊断结节病的敏感性为73%，特异性为83%。诊断特异性为100%，敏感性为73%。血清ACE水平与全身的结合（67）GA扫描提高了胸部正常或可疑的临床可疑眼结节病患者的诊断特异性，而不影响敏感性X光片
Purpose: To evaluate the role of combined serum angiotensin-converting enzyme (ACE) activity and whole-body gallium ((67)GA) scanning in diagnosing sarcoidosis in patients with features consistent with ocular sarcoidosis but with normal or equivocal chest radiographs.Methods: Serum ACE levels and whole-body (67)GA scans were obtained as part of the initial workup in 22 patients with active ocular inflammation and ultimately biopsy-proven sarcoidosis (sarcoid uveitis group). A second group consisting of 70 patients with active uveitis in whom sarcoidosis also was considered a diagnostic possibility also was studied, All 70 patients ultimately had a definitive diagnosis other than sarcoidosis (nonsarcoid uveitis), All patients in this group also had a serum ACE and whole-body (67)GA scan performed as part of their initial investigations.Results: All patients in the sarcoid uveitis group had either an elevated ACE level or an abnormal scan. In 16 of the 22 patients, results of both tests were abnormal, in no patient in the nonsarcoid uveitis group were results of both tests abnormal, The sensitivity of an elevated ACE in diagnosing sarcoidosis was 73% and the specificity was 83%, Using the combination of a positive (67)GA scan and an elevated ACE, the specificity for diagnosis was 100% and the sensitivity was 73%.Conclusions: The combination of serum ACE level and whole-body (67)GA scan increases the diagnostic specificity without affecting sensitivity in patients with clinically suspicious ocular sarcoidosis who have normal or equivocal chest radiographs.