From the Guidelines
The Endomysial Antibody (EMA) test is used to diagnose Celiac Disease, a chronic autoimmune disorder that causes the immune system to react to gluten.
Key Points
- The test detects the presence of antibodies against tissue transglutaminase, an enzyme found in the small intestine, which is a specific indicator of Celiac Disease 1.
- A positive EMA test result suggests that a person has an immune response to gluten and may have Celiac Disease.
- The EMA test has a high specificity of 99.6% 1, making it a reliable tool for confirming the diagnosis of Celiac Disease.
- The test is often used as a second-line confirmatory test due to its high specificity and is particularly useful in cases where the initial screening test results are unclear or inconclusive 1.
- It is essential to note that the EMA test is more labor-intensive and operator-dependent compared to other serologic tests, such as the IgA tTGA test 1.
- The EMA test is based on antibody reactivity to tissue-bound TG-2 and is typically performed using an indirect immunofluorescence assay on primate esophagus or human umbilical cord 1.
From the Research
Endomysial Antibody Test
The endomysial antibody (Endomysial Ab) test is used for the diagnosis of celiac disease (CD) [(2,3,4)].
Purpose of the Test
- The test detects the presence of IgA endomysial antibodies (EMA) in the blood, which are specific markers of celiac disease [(2,4)].
- It is used as a confirmatory test for the diagnosis of CD, particularly in the no-biopsy approach 5.
- The test can also be used to monitor the effectiveness of a gluten-free diet in patients with CD 6.
Characteristics of the Test
- The test has high specificity for celiac disease, meaning that a positive result is highly indicative of the disease [(2,3,4)].
- However, the sensitivity of the test may be lower, particularly in patients who have been on a gluten-free diet for some time 6.
- The test can be performed using various substrates, including monkey esophagus, human umbilical cord, and cell-assembled biomatrix 3.
Clinical Applications
- The endomysial antibody test is used in the diagnosis of celiac disease in patients with symptoms such as chronic diarrhea, abdominal pain, and weight loss 4.
- It is also used to monitor the response to treatment in patients with CD 6.
- The test may be used in conjunction with other tests, such as anti-tissue transglutaminase antibody tests, to confirm the diagnosis of CD 5.