9165. Endomysium, IgG antibodies (method IFT)

Anti-endomysial antibodies (anti-EMA) are autoantibodies that specifically react with the connective tissue surrounding muscle fibers (the endomysium). Their main antigen is the enzyme tissue transglutaminase (tTG), a key protein involved in the development of the autoimmune response associated with celiac disease.

Anti-EMA testing is used to screen patients with suspected celiac disease, particularly those at increased risk, as well as to monitor treatment – anti-EMA levels decrease when a gluten-free diet is followed.

As part of a comprehensive assessment, testing for antibodies to deamidated gliadin peptides, antibodies to tissue transglutaminase, and IgA antibodies to endomysium is recommended.

Endomysium is connective tissue that surrounds smooth muscle cells. In genetically predisposed individuals, gluten consumption may trigger the development of an immune-mediated inflammatory disease of the small intestine – celiac disease, which is characterized by the production of autoimmune antibodies against extracellular matrix structures, particularly endomysium and reticulin.

When total IgA levels are low, testing for IgG antibodies to endomysium should be included in the laboratory assessment. After switching to a gluten-free diet, antibody levels decrease within 6–12 months.

These antibodies are present in 70–80% of patients with dermatitis herpetiformis. In celiac disease, the sensitivity of anti-endomysial antibodies is 99%, and their specificity is 100%.

• Diagnosis of dermatitis herpetiformis and celiac disease.
• Monitoring adherence to a gluten-free diet in patients with dermatitis herpetiformis and celiac disease.
• Due to the high specificity of anti-endomysial antibodies, the test can help avoid obtaining multiple small intestinal biopsy samples to confirm a diagnosis of celiac disease. This is particularly important in pediatric practice when assessing growth retardation in children.

• Venous blood

In order to exclude factors that may affect the test results, we recommend to follow the preparation rules: