If you have celiac disease, your immune system responds abnormally to a protein called gluten. Gluten is found in wheat, barley, and rye products. Your body makes antibodies to the gluten called endomysial antibodies (EMA). These autoantibodies cause your intestine to swell. If they aren't found, the disease can damage the lining of your small intestine. They can also keep your body from fully absorbing nutrients from food. Long-term (chronic) swelling and increasing damage to the small intestine leads to malnutrition, among other problems.
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.
- Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
- Negative in normal individuals; also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.
- A negative result (absence of circulating IgA-endomysial antibodies) does not exclude the diagnosis of dermatitis herpetiformis or celiac disease.
Additional note: 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 (tTG) Antibody, IgA, Serum and IGA / Immunoglobulin A (IgA), Serum levels are recommended.
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.
IgA anti-endomysial antibodies are found in 90% celiac patients. They are a very specific & sensitive marker for celiac disease and dermatitis herpetiformis. The anti-endomysial antibody test has been suggested to be 98% sensitive and 98% specific for clinical or subclinical celiac disease. Since celiac disease is commonly associated with IgA deficiency, care must be exercised in diagnosing these patients since clearly they do not express IgA antibodies.
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