Test Id : EMA
Endomysial Antibodies, IgA, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Analysis of IgA-endomysial antibodies for the diagnosis of dermatitis herpetiformis and celiac disease
Monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis and celiac disease
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| EMAT | EMA Titer, S (IgA) | No | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the IgA-endomysial antibodies result is positive or indeterminate, then the antibody titer will be performed at an additional charge.
The following algorithms are available:
-Celiac Disease Comprehensive Cascade Test Algorithm
-Celiac Disease Diagnostic Testing Algorithm
-Celiac Disease Gluten-Free Cascade Test Algorithm
Method Name
A short description of the method used to perform the test
Indirect Immunofluorescence Assay (IFA)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Anti-Endomysial Antibody
Antiendomysial Antibody
Antimesothelial Antibody
Celiac Disease
Coeliac Disease
Cutaneous Immunofluorescence
Dermatitis herpetiformis
Dermatoimmunopathology
EA
EMA
Failure to Thrive
Gluten-sensitive Enteropathy
IgA Antibodies
Immunodermatology
Immunofluorescence Antibodies
Immunopathology
Malabsorption
Sprue
Celiac Disease (order DGLDN, RTA, EMA)
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the IgA-endomysial antibodies result is positive or indeterminate, then the antibody titer will be performed at an additional charge.
The following algorithms are available:
-Celiac Disease Comprehensive Cascade Test Algorithm
-Celiac Disease Diagnostic Testing Algorithm
-Celiac Disease Gluten-Free Cascade Test Algorithm
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
Cascade testing is recommended for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation.
-For complete testing excluding HLA DQ, order CDSP / Celiac Disease Serology Cascade, Serum
-For patients already adhering to a gluten-free diet, order CDGF / Celiac Disease Gluten-Free Cascade, Serum and Whole Blood
To order individual tests, see Celiac Disease Diagnostic Testing Algorithm
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 30 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Analysis of IgA-endomysial antibodies for the diagnosis of dermatitis herpetiformis and celiac disease
Monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis and celiac disease
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
If the IgA-endomysial antibodies result is positive or indeterminate, then the antibody titer will be performed at an additional charge.
The following algorithms are available:
-Celiac Disease Comprehensive Cascade Test Algorithm
-Celiac Disease Diagnostic Testing Algorithm
-Celiac Disease Gluten-Free Cascade Test Algorithm
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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, this 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.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative in normal individuals; also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.
Interpretation
Provides information to assist in interpretation of the test results
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. For more information see TTGA / Tissue Transglutaminase Antibody, IgA, Serum and IGA / Immunoglobulin A (IgA), Serum.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A negative result (absence of circulating IgA-endomysial antibodies) does not exclude
Patients with mild gluten-sensitive enteropathy may have a negative
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Peters MS, McEvoy MT. IgA antiendomysial antibodies in dermatitis herpetiformis. J Am Acad Dermatol. 1989;21(6):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(4):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. 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
Describes how the test is performed and provides a method-specific reference
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)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86231
86231-titer (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| EMA | Endomysial Abs, S (IgA) | 46126-9 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 9360 | Endomysial Ab | 46126-9 |