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HelpMayo Test ID EMAT Endomysial Antibodies, IgA, Titer, Serum
Specimen Required
Only orderable as a reflex. For more information see EMA / Endomysial Antibodies, IgA, Serum.
Method Name
Only orderable as a reflex. For more information see EMA / Endomysial Antibodies, IgA, Serum.
Indirect Immunofluorescence Assay (IFA)
Reporting Name
EMA Titer, S (IgA)Specimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 30 days | ||
| Ambient | 14 days |
Reference Values
Only orderable as a reflex. For more information see EMA / Endomysial Antibodies, IgA, Serum.
Negative
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86231
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| EMAT | EMA Titer, S (IgA) | 27038-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 65091 | EMA Titer, S (IgA) | 27038-9 |
Useful For
Confirmation of a positive IgA-endomysial antibodies result
Clinical Information
Circulating IgA endomysial antibodies are present in 70% to 80% of patients with dermatitis herpetiformis or celiac disease, and in nearly all such patients who have high grade gluten-sensitive enteropathy and are not adhering to a gluten-free diet.
Because of the high specificity of endomysial antibodies for celiac disease, the test may obviate the need for multiple small bowel biopsies to verify the diagnosis. This may be particularly advantageous in the pediatric population, including the evaluation of children with failure to thrive.
Interpretation
The finding of IgA-endomysial antibodies (EMA) is highly specific for dermatitis herpetiformis or celiac disease.
The titer of IgA-EMA generally correlates with the severity of gluten-sensitive enteropathy.
If patients strictly adhere to a gluten-free diet, the titer of IgA-EMA should begin to decrease within 6 to 12 months of onset of dietary therapy.
Occasionally, the staining results cannot be reliably interpreted as positive or negative because of strong smooth muscle staining, weak EMA staining, or other factors. In these cases, the results will be reported as "indeterminate," and additional testing is recommended; see TTGA / Tissue Transglutaminase Antibody, IgA, Serum and IGA / Immunoglobulin A (IgA), Serum.
Cautions
A negative result (absence of circulating IgA-endomysial antibodies) does not exclude the diagnosis of dermatitis herpetiformis or celiac disease.
Patients with mild gluten-sensitive enteropathy may have a negative result.
Clinical Reference
1. Peters MS, McEvoy MT. IgA antiendomysial antibodies in dermatitis herpetiformis. J Am Acad Dermatol. 1989;21(6):1225-1231. doi:10.1016/s0190-9622(89)70335-2
2. Chorzelski TP, Buetner EH, Sulej J, et al. IgA anti-endomysium antibody: a new immunological marker of dermatitis herpetiformis and coeliac disease. Br J Dermatol. 1984;111(4):395-402. doi:10.1111/j.1365-2133.1984.tb06601.x
3. Kapuscinska A, Zalewski T, Chorzelski TP, et al. Disease specificity and dynamics of changes in IgA class anti-endomysial antibodies in celiac disease. J Pediatr Gastroenterol Nutr. 1987;6(4):529-534. doi:10.1097/00005176-198707000-00006
4. Elwenspoek MMC, Jackson J, Dawson S, et al. Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol. BMJ Open. 2020;10(10):e038994. doi:10.1136/bmjopen-2020-038994
Method Description
Frozen sections of primate esophagus substrate are overlaid with dilutions of patient's serum, incubated, covered with fluorescein-conjugated IgA antiserum, and interpreted with a fluorescence microscope.(Package insert: NOVA Lite Monkey Oesophagus IFA Kit/Slides. Inova Diagnostics; 05/2018; Chorzelski TP, Beutner EH, Sulej J, et al. IgA anti-endomysium antibody: a new immunological marker of dermatitis herpetiformis and coeliac disease. Br J Dermatol. 1984;111[4]:395-402. doi:10.1111/j.1365-2133.1984.tb06601.x; Kupascinska A, Zalewski T, Chorzelski TP, et al. Disease specificity and dynamics of changes in IgA class anti-endomysial antibodies in celiac disease. J Pediatr Gastroenterol Nutr. 1987;6[4]:529-534. doi:10.1097/00005176-198707000-00006)
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Day(s) Performed
Monday through Friday