MICHAEL S. ROHRBACH, PH.D.; STEVEN KOSSARD, M.B., PH.D.; R. K. WINKELMANN, M.D.
ROHRBACH MS, KOSSARD S, WINKELMANN RK. Serum Angiotensin-Converting Enzyme in Granuloma Annulare. Ann Intern Med. 1979;90:441. doi: 10.7326/0003-4819-90-3-441_1
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Published: Ann Intern Med. 1979;90(3):441.
To the editor: Lieberman and Rea (1) have recently shown that elevated levels of serum angiotensin-converting enzyme are not confined to patients with sarcoidosis but can also be found in patients with leprosy and Gaucher's disease. In contrast, patients with deep fungal granulomas and tuberculosis usually have normal levels of this enzyme.
Granuloma annulare is a cutaneous disorder that shares some of the characteristics of sarcoidosis. Both are granulomas of unknown cause, and elevated levels of serum macrophage migration inhibiting factors have been seen in both (2). Although cutaneous sarcoidosis and generalized granuloma can usually be differentiated clinically, the two
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