Low ACE levels are associated with which disease?

• A. Scleroderma
• B. Sarcoidosis
• C. Rheumatoid Arthritis
• D. Psoriasis

Answer: (A)

ACE levels in the serum are most notably elevated in sarcoidosis. This happens because granulomas in sarcoidosis contain macrophages that produce ACE, so the enzyme is released into the blood and can help support the diagnosis when interpreted alongside clinical and imaging findings. Low ACE levels are not a characteristic feature of scleroderma, rheumatoid arthritis, or psoriasis; these conditions don’t rely on ACE as a diagnostic marker, and in scleroderma, ACE inhibitors are used as a treatment to protect kidney function, not to indicate a baseline low ACE state. So the commonly understood pattern is that ACE goes up in sarcoidosis, not down, making the idea that low ACE is associated with these rheumatic diseases not consistent with typical clinical knowledge.