University of Iowa
Diagnostic Laboratories
(UIDL) Test Directory

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Endomysial IgG Antibody Screen with Reflex Titer and Interpretation
Order Code: EMAIGG
Order Form: Immunopathology Requisition
Specimen:
Serum
Collection Medium:
Red top tube
Minimum:
Adult - 5 mL; red top tube
Pediatric - 2 mL; red top tube
Testing
Schedule:
Bi-weekly (Mon and Thurs) - Batch analysis performed 
twice weekly on Mondays and Thursdays excluding 
university holidays.
Analytic Time:
1 week
Reference Range:
< 1:5 Titer;  Endomysial IgG antibody is useful in screening for celiac 
disease or dermatitis herpetiformis in patients with selective IgA 
deficiency. Selective IgA deficiency affects 3-5% of celiac and 
dermatitis herpetiformis patients. Endomysial IgG testing is not 100% 
sensitive for detection of such patients and it is recommended that 
anti-tissue transglutaminase EIA also be ordered for best sensitivity.

70-76% of patients with dermatitis herpetiformis and 90+% of patients 
with celiac disease who are on a gluten-containing diet.  Occurence of 
endomysial IgA antibody decreases significantly on gluten-free diets.
Note: Selective IgA deficiencies affects 10-15% of celiac and DH 
patients and this condition will cause a false negative test.  If IgA 
deficiency is known, please note on the requisition and IgG anti-EMA 
test will be done instead of IgA.
Comments:
Include relevant clinical information and consultation request.
Methodology:
Indirect Immunofluorescence
Sample
Processing:
Centrifuge at 3500 RPM for 5 minutes.
Aliquot serum into labeled container and cap.
Sample
Storage:
Refrigerate serum 2-8 degree C.
Transport
Instructions:
Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Ship at ambient temperature.
CPT Code:
86255    Endomysial Antibody IgG screen
86255-26 Endomysial Antibody IgG screen interpretation
86256    Endomysial Antibody IgG titer
86256-26 Endomysial Antibody IgG titer interpretation

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Updated: 03/25/2009