Examinations
Examinations
Endomysium is a connective tissue layer that surrounds individual skeletal muscle fibers. In certain autoimmune diseases, the body produces anti-endomysial antibodies (EMA), which target proteins in the endomysium.
Clinical Significance
- EMA antibodies (IgA and IgG) are primarily used in diagnosing celiac disease.
- IgA is the preferred marker, but IgG is tested in patients with IgA deficiency, which is common in celiac disease.
- Elevated EMA IgG antibodies strongly suggest gluten-sensitive enteropathy (celiac disease).
- Take the test at least 2 hours after the last meal.
- Avoid smoking for 3 hours before the test.
- Avoid physical and emotional stress for 1 hour before the test.
This test is recommended if celiac disease is suspected, particularly if the patient has:
Gastrointestinal Symptoms:
- Chronic diarrhea
- Weight loss
- Abdominal bloating and excessive gas
- Abdominal pain
- Nausea and vomiting
- Flatulence
Non-Gastrointestinal Symptoms (Common in Adults):
- Iron deficiency anemia
- Loss of bone density (osteoporosis) or softening of bones (osteomalacia)
- Itchy, blistering skin rash (dermatitis herpetiformis)
- Mouth ulcers
- Headaches and fatigue
- Neurological symptoms (numbness, tingling, balance problems, cognitive impairment)
- Joint pain
- Reduced spleen function (hyposplenism)
Elevated EMA IgG Levels:
- Strongly indicate celiac disease (gluten-sensitive enteropathy).
- Commonly detected in IgA-deficient patients with celiac disease.
- Levels correlate with gluten consumption (titers decrease on a gluten-free diet).
- Also found in dermatitis herpetiformis, a skin condition associated with gluten intolerance.
Negative EMA IgG Test:
- Suggests the absence of celiac disease.
- However, further testing (tTG-IgG, total IgA) may be needed if celiac disease is strongly suspected.