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Test Code EMAT Endomysial Antibodies, IgA, Titer, Serum

Secondary ID

65091

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

Serum


Specimen Required


Only orderable as a reflex. For more information see EMA / Endomysial Antibodies, IgA, Serum.


Specimen 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 U.S. Food and Drug Administration.

CPT Code Information

86256

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 this case, the results will be recorded as "indeterminate." In this setting, further testing with measurement of TTGA / Tissue Transglutaminase Antibody, IgA, Serum and IGA / Immunoglobulin A (IgA), Serum levels are recommended.

Clinical Reference

1. Peters MS, McEvoy MT: IgA antiendomysial antibodies in dermatitis herpetiformis. J Am Acad Dermatol. 1989;21:1225-1231

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;111:395-402

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. 1984;6:529-534

4. Elwenspoek MMC, Jackson J, Dawson S, et al: Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol. BMJ Open. 2020 Oct 5;10(10):e038994. doi: 10.1136/bmjopen-2020-038994