Imperial Collage Healthcare

CSF Angiotensin Converting Enzyme (CSF ACE)


Lab Code : CSF (ACE): We no longer offer this service


Test Background

15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 

Diagnosis is of neurosarcoidosis (NS) is notoriously difficult and usually relies on the exclusion of other causes. NS usually only develops in patients with significant systemic sarcoidosis, however some patients may develop NS prior to being diagnosed with sarcoidosis. As a result patient workup can be challenging. Angiotensin converting enzyme in cerebrospinal fluid (CSF ACE) has been reported to be a potentially useful biomarker in aiding the diagnosis of NS. Although non-specific, CSF ACE is thought to be increased in approximately 50% of all NS patients.

 


Clinical Indications

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 

All current samples pending for analysis can either be forwarded to the National Hospital for Neurology and Neuroscience at Queen Square London, returned directly to your laboratory or disposed of. Please contact the laboratory directly to instruct us regarding how you would like us to handle your samples using the contact details below: 

Carmel Wood
Tel: 0203 311 7062
Email: carmel.wood2@nhs.net
Laboratory Manager, Clinical Biochemistry, 1st Floor Lab Block, Charing Cross Hospital, North West London Pathology

Alan Courtney
Tel: 0203 311 5187
Email: alan.courtney@nhs.net
Principal Clinical Scientist, Clinical Biochemistry, 8th Floor Lab Block, Charing Cross Hospital, North West London Pathology

 

NS usually only develops in patients with significant systemic sarcoidosis. It is thought that approximately 5 – 15% of sarcoidosis patients may develop NS, but around half of these individual are subclinical. Symptoms may include: headaches, visual, ataxia, vomiting, cranial neuropathy (presenting feature in ~50% cases). 

 


Reference Range

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 

Normal Range                      ≤ 2.0 U/L

Borderline High Results         1.5 – 2.0 U/L

High Results                        > 2.0 U/L


Sample Required
CSF in universal container samples (EDTA and Fluoride interfere with the assay and are unsuitable).


Sample Container

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 


Sample Collection

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 


Sample Volume
300 µL (500 µL preferred)


Transport/Storage

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 

It is recommended that all samples are promptly stored at 4°C and where possible frozen at -20°C. 


Turnaround Time

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 


4 weeks


Notes

From 15 May 2019:

We regret to inform you that due to unforeseen and significant problems with our CSF ACE assay, we can no longer offer this service. 

Patients on ACE inhibitors may produce significantly lower results (often below the limit of detection).  


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