PS. GG, when I say "the fastest route to dx" my doctor had focused in on MS but I wasn't. A LP doesn't rule out MS in absence of a negative LP but it can confirm a dx so my attitude in proceeding with the LP had little to do with MS but in the other possibilites. I specifically did the test for all the other things it does rule in/out. We had different motives but each test I've taken has given a clearer picture to my dx which falls down the same path with Bob's post. Ruling out the other possibilities. :)
I haven't read that ACE levels can be high in MS patients. I have heard it isn't uncommon for anyone with auto-immune diseases to have more than one disease.
Neuro-sarcoid is MS mimic so it's a warning sign to be concerned about. I would definitely do the LP as I was informed by several Neuro's that Neuro-sarcoid is difficult to dx without a biopsy (of the lesions in the brain) so I'd opt for the LP over a biopsy any day.
I did the LP because my doctor indicated it was the quickest route to a dx without lesions (as my 1st two MRIs radiology reports didn't catch the lesion that was there) as it does rule in/out many other rare diseases, illnesses and cancers. I was worried about cancer lurking behind the scenes so the LP was worth it to me...actually a fast dx of my Neuro symptoms was worth it to me. I suspect I will have another one in my future as mine was negative (for everything) despite now being probable MS.
The LP wasn't that bad. I ended up with the headache as well and if I had received better instructions I would have gone to the ER much sooner. That is the key - if you get the headache get back to the doctor RIGHT AWAY, they can do things for you sooner than waiting the 4 days that I waited.
Oh. both results were non-fasting. I'll look into that aspect of the result. I didn't know it was fasting/non-fasting sensitive.
I guess the first question is "Did you fast 12 hours prior to the test?" since this 40 microgram per liter upper level is a fasting value? Increased ACE levels may be a sign of sarcoidosis. However, increased ACE levels may also be seen in several other disorders, including: Active histoplasmosis,
Amyloidosis, Asbestosis, Berylliosis, Diabetes, Emphysema, Gaucher's disease, Hepatitis, Hodgkin's disease, Hyperthyroidism, Idiopathic pulmonary fibrosis, Leprosy....etc.
http://www.nlm.nih.gov/medlineplus/ency/article/003567.htm
It is not a very specific test.
Bob
(ps: I take Lisinopril for high blood pressure which is an ACE inhibitor and can cause low ACE levels on the test.)