Test Catalog

Test Id : EMAIG

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Endomysial Antibodies, IgG, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Analysis of IgG-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
EMAGT EMA Titer (IgG), S No No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If the IgG-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

-Celiac Disease Routine Treatment Monitoring Algorithm

-Celiac Disease Serology 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.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Endomysial Abs (IgG), S

Aliases
Lists additional common names for a test, as an aid in searching

Anti-Endomysial Antibody

Antiendomysial Antibody

Antimesothelial Antibody

Celiac Disease

Celiac Disease (order DGLDN, RTA, EMA)

Coeliac Disease

Cutaneous Immunofluorescence

Dermatitis herpetiformis

Dermatoimmunopathology

EA

EMA

Failure to Thrive

Gluten-sensitive Enteropathy

IgG Antibodies

Immunodermatology

Immunofluorescence Antibodies

Immunopathology

Malabsorption

Sprue

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If the IgG-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

-Celiac Disease Routine Treatment Monitoring Algorithm

-Celiac Disease Serology 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 cascade tests are available; select the appropriate one for your specific patient situation.

-For complete testing including human leukocyte antigen (HLA) DQ, order CDCOM / Celiac Disease Comprehensive Cascade, Serum and Whole Blood

-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) with the specimen.

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
Frozen 30 days
Ambient 14 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Analysis of IgG-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 IgG-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

-Celiac Disease Routine Treatment Monitoring Algorithm

-Celiac Disease Serology Cascade Test Algorithm

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Circulating IgG 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.

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 patients with either dermatitis herpetiformis or celiac disease while adhering to gluten-free diet.

Interpretation
Provides information to assist in interpretation of the test results

The finding of IgG-endomysial antibodies (EMA) is highly specific for dermatitis herpetiformis or celiac disease.

 

The titer of IgG-EMA generally correlates with the severity of gluten-sensitive enteropathy.

 

If patients strictly adhere to a gluten-free diet, the titer of IgG-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 IGG / Immunoglobulin G (IgG), Serum levels are recommended.

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 IgG-endomysial antibodies) does not exclude the diagnosis of dermatitis herpetiformis or celiac disease.

 

Patients with mild gluten-sensitive enteropathy may have a negative result.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Dahlbom I, Olsson M, Forooz NK, Sjoholm AG, Truedsson L, Hannson T. Immunoglobulin G (IgG) anti-tissue transglutaminase antibodies used as markers for IgA-deficient celiac disease patients. Clin Diagn Lab Immunol. 2005;12(2): 254-258. doi:10.1128/CDLI.12.2.254-258.2005

2. Korponay-Szabo IR, Dahlbom I, Laurila K, et al. Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency. Gut. 2003;52(11):1567-1571. doi:10.1136/gut.52.11.1567

3. Kumar V, Jarzabek-Chorzelska M, Sulej J, Karnewska K, Farrell T, Jablonska S. Celiac disease and immunoglobulin A deficiency: How effective are the serological methods of diagnosis? Clin Diagn Lab Immunol. 2002;9(6):1295-1300. doi:10.1128/CDLI.9.6.1295-1300.2002

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 IgG 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

No

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.

2 to 7 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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.

86231-screen

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
EMAIG Endomysial Abs (IgG), S 39554-1
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.
608880 Endomysial IgG Ab, S 39554-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports