Test Code EMA Endomysial Antibodies (IgA), Serum
Reporting Name
Endomysial Abs, S (IgA)Useful For
Diagnosis of dermatitis herpetiformis and celiac disease
Monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis and celiac disease
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.
Performing Laboratory

Specimen Type
SerumAdvisory Information
-CDCOM / Celiac Disease Comprehensive Cascade: complete testing including HLA DQ
-CDSP / Celiac Disease Serology Cascade: complete testing excluding HLA DQ
-CDGF / Celiac Disease Gluten-Free Cascade: for patients already adhering to a gluten-free diet
To order individual tests, see Celiac Disease Diagnostic Testing Algorithm in Special Instructions.
Specimen Required
Container/Tube:
Preferred: Serum gel
Acceptable: Red Top
Specimen Volume: 2 mL
Specimen Minimum Volume
Adults: 1 mL
Pediatric: 0.5 mL
Testing Algorithm
If EMA / Endomysial Antibodies (IgA), Serum is positive or indeterminate, EMAT / Endomysial (IgA), Titer, Serum will be performed at an additional charge.
The following algorithms are available in Special Instructions:
-Celiac Disease Comprehensive Cascade
-Celiac Disease Diagnostic Testing Algorithm
-Celiac Disease Gluten-Free Cascade
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 30 days | ||
Ambient | 14 days |
Special Instructions
Reference Values
Negative in normal individuals; also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.
Day(s) and Time(s) Performed
Monday through Friday; 7 a.m.-5 p.m.
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
86255-screen
86256-titer (if appropriate)
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
EMA | Endomysial Abs, S (IgA) | 46126-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
9360 | Endomysial Ab | 46126-9 |
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 Nutr1984;6:529-534
Method Description
Frozen sections of rhesus monkey esophagus substrate are overlaid with dilutions of patient's serum, incubated, covered with fluorescein-conjugated IgA antiserum, and interpreted with a fluorescence microscope.(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;111:395-402; 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;6:529-534)
Analytic Time
2 daysReject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Method Name
Staining of Rhesus Monkey Esophagus Substrate by Indirect Immunofluorescence Assay (IFA) for IgA Endomysial Antibodies (EMA)
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
EMAT | EMA Titer, S (IgA) | No | No |