Endomysial Antibodies, IgG, Serum

Casandra

Casandra Test Code MC65824Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID EMAIGCPT Code 86231

Endomysial Antibodies, IgG, Serum

Clinical Use

Use

The test is primarily used for the analysis of IgG-endomysial antibodies to diagnose dermatitis herpetiformis and celiac disease. Additionally, it serves as a tool to monitor adherence to a gluten-free diet in patients diagnosed with these conditions. The presence of circulating IgG endomysial antibodies is indicative of gluten-sensitive enteropathy, commonly found in celiac disease patients who are not adhering to a gluten-free diet. This test's high specificity for celiac disease can often eliminate the need for multiple small bowel biopsies, which is particularly beneficial for pediatric evaluations.

Special Instructions

Cascade testing is recommended for celiac disease to ensure an algorithmic progression in testing. For thorough testing including or excluding HLA DQ, specific cascade orders are available. For instance, CDCOM / Celiac Disease Comprehensive Cascade includes HLA DQ typing and serum IgA tests, whereas CDSP / Celiac Disease Serology Cascade excludes HLA DQ. Patients on a gluten-free diet should consider the CDGF / Celiac Disease Gluten-Free Cascade. It's vital for non-electronic orders to complete and include the Gastroenterology and Hepatology Test Request with the specimen.

Limitations

A negative IgG-endomysial antibody result does not definitively exclude dermatitis herpetiformis or celiac disease, especially in mild cases of gluten-sensitive enteropathy. The test may return indeterminate results due to factors like strong smooth muscle staining or weak EMA staining. In such instances, further assessment with additional immunoglobulin testing is recommended. While highly specific, the test may not capture all nuances and should be interpreted within the larger clinical context.

Test Details

New York Approved