Sign in →

Endomysial Antibodies, IgA, Serum

Important Note

The recommended screening test for celiac disease is Tissue Transglutaminase Antibody IgA (TTG IgA).  EMA is orderable as a MISC when ordered by Seattle Children's gastroenterologists (GI) under the following circumstances:

  • Patient has signs/symptoms of celiac disease
  • TTG IgA elevated >150 U/L
  • Patient does not have T1D, T21

If a provider wishes to discuss Endomysial Antibody, IgA (EMA) testing further, a faculty member may be reached through Laboratory Client Services at (206) 987-2617 or at

Reporting Name

Endomysial Abs, S (IgA)
Seattle Children's Hospital Note:

SCH Clinical System Name: Miscellaneous Test

Useful For

Analysis of IgA-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

If the IgA-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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type


Ordering Guidance

Cascade testing is recommended for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades 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

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 2 mL

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  30 days
  Ambient  14 days

Reference Values

Negative in normal individuals; also negative in dermatitis herpetiformis or celiac disease patients adhering to gluten-free diet.

Day(s) Performed

Monday through Friday

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 US Food and Drug Administration.

CPT Code Information


86231-tier (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

Method Description

Frozen sections of primate esophagus substrate are overlaid with dilutions of patient's serum, incubated, covered with fluorescein-conjugated IgA antiserum, and interpreted with a fluorescence microscope.(Package insert: NOVA Lite Monkey Oesophagus IFA Kit/Slides. Inova Diagnostics; 05/2018)

Report Available

2 to 7 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Method Name

Indirect Immunofluorescence Assay (IFA)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
EMAT EMA Titer, S (IgA) No No


If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Client Test Request (T728) with the specimen.