A 34-year-old woman with bilateral granulomatous anterior uveitis is found to have 'candle-wax drippings' along the retinal venules and snowball opacities in the vitreous. Chest imaging shows bilateral hilar lymphadenopathy. Which laboratory finding best supports the underlying systemic diagnosis?
- A Positive antinuclear antibody
- B Positive HLA-B27
- C Elevated serum angiotensin-converting enzyme level ✓
- D Elevated serum IgA
Correct answer: C. Elevated serum angiotensin-converting enzyme level
Explanation
The candle-wax periphlebitis, snowballs, granulomatous uveitis, and bilateral hilar lymphadenopathy point to sarcoidosis. Serum ACE reflects granuloma burden in active sarcoid and supports the diagnosis, though it lacks perfect sensitivity and specificity. HLA-B27 belongs to acute anterior uveitis with ankylosing spondylitis, ANA is a marker for juvenile idiopathic arthritis uveitis screening, and raised IgA has no role here.
Reference: Yanoff and Duker Ophthalmology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.