The Endomysial Antibody Scr (Iga) W/Refl To Titer test contains 1 test with 1 biomarker.
Brief Description: The Endomysial IgA Antibody Screen with Reflex to Titer test is a serologic assay used primarily to assist in the diagnosis of celiac disease. This test detects antibodies targeting the endomysium, which is a connective tissue layer that surrounds muscle fibers. A reflex to titer means that if the screening is positive, the lab will then measure the amount or "titer" of the antibodies present, which can give an indication of the severity or stage of the disease.
IMPORTANT - If Endomysial IgA Antibody Screen is positive, Endomysial Antibody Titer will be performed by the lab for an additional charge of $48.50
Collection Method: Blood Draw
Specimen Type: Serum
Test Preparation: No preparation required
When and Why a Endomysial IgA Antibody Screen with Reflex to Titer Test May Be Ordered
Healthcare providers may order this test when a patient shows symptoms suggestive of celiac disease. These symptoms can be quite broad, ranging from digestive issues (such as diarrhea, bloating, or abdominal pain) to more systemic signs like fatigue, joint pain, or skin rashes.
Additionally, it might be ordered if:
- A patient has family members with celiac disease, increasing their risk.
- A patient with another autoimmune disorder is experiencing unexplained symptoms since celiac disease can coexist with other autoimmune conditions.
- To monitor the effectiveness of a gluten-free diet in diagnosed patients.
What a Endomysial IgA Antibody Screen with Reflex to Titer Test Checks For
This test screens for the presence of IgA antibodies directed against endomysium. If these antibodies are present, it suggests the individual's immune system is reacting against its tissues, specifically targeting the lining of the small intestine, as seen in celiac disease.
Other Lab Tests Ordered Alongside a Endomysial IgA Antibody Screen with Reflex to Titer Test
When an Endomysial IgA Antibody Screen test is ordered, it's often part of a broader evaluation for celiac disease and related gastrointestinal conditions. Here are some tests commonly ordered alongside it:
Tissue Transglutaminase Antibody (tTG-IgA) Test:
- Purpose: To detect antibodies against tissue transglutaminase, a common screening and diagnostic tool for celiac disease.
- Why Is It Ordered: tTG-IgA is highly sensitive and specific for celiac disease and is often used in conjunction with endomysial antibodies for diagnosis.
Total Serum IgA:
- Purpose: To measure the level of IgA antibodies in the blood.
- Why Is It Ordered: To check for IgA deficiency, which can cause false-negative results in IgA-based celiac disease tests like the tTG-IgA and endomysial antibody tests.
Deamidated Gliadin Peptide (DGP) Antibody Test (IgA and IgG):
- Purpose: To detect antibodies against deamidated gliadin peptides, which are formed during the digestion of gluten.
- Why Is It Ordered: Useful in the diagnosis of celiac disease, especially in individuals with IgA deficiency or atypical serological results.
Complete Blood Count (CBC):
- Purpose: To evaluate overall blood health.
- Why Is It Ordered: To identify signs of anemia or other blood cell abnormalities that can occur with celiac disease due to malabsorption.
Iron, Folate, and Vitamin B12 Levels:
- Purpose: To measure the levels of these nutrients in the blood.
- Why Is It Ordered: To assess for deficiencies commonly associated with celiac disease due to malabsorption in the damaged small intestine.
Vitamin D Level:
- Purpose: To assess vitamin D status.
- Why Is It Ordered: Individuals with celiac disease often have vitamin D deficiency due to malabsorption.
Calcium and Magnesium Levels:
- Purpose: To measure the levels of calcium and magnesium in the blood.
- Why Is It Ordered: To evaluate for deficiencies that may occur in celiac disease due to malabsorption.
These tests, when ordered alongside an Endomysial IgA Antibody Screen test, provide a comprehensive evaluation for celiac disease and help in diagnosing the condition. They are crucial for confirming the diagnosis, assessing the extent of nutrient deficiencies and intestinal damage, and guiding dietary management and treatment. The specific combination of tests will depend on the individual’s symptoms, clinical history, and the likelihood of celiac disease.
Conditions or Diseases Requiring a Endomysial IgA Antibody Screen with Reflex to Titer Test
- Celiac Disease: An autoimmune condition where the ingestion of gluten leads to damage in the small intestine. The primary condition this test helps diagnose.
How Health Care Providers Use the Results of a Endomysial IgA Antibody Screen with Reflex to Titer Test
A positive result (indicating the presence of endomysial IgA antibodies) is strongly suggestive of celiac disease, especially when accompanied by typical symptoms. The titer, or the amount of antibody present, can give an indication of the severity or activity of the disease.
If a patient is already on a gluten-free diet and the titer decreases or the antibodies disappear, it can be an indication that the diet is effective and the intestinal damage is healing.
However, no test is perfect. A negative result does not completely rule out celiac disease, especially if the patient has selective IgA deficiency or if they have been on a strict gluten-free diet for a prolonged period before testing.
In the case of suggestive clinical symptoms but negative serology, a small intestine biopsy might be considered. On the other hand, a positive serological test, especially if the titer is high, might be followed up with a biopsy to confirm the diagnosis and assess the extent of intestinal damage.
Most Common Questions About the Endomysial IgA Antibody Screen with Reflex to Titer test:
Purpose and Clinical Indications
Why is the Endomysial IgA Antibody Screen with Reflex to Titer test ordered?
The Endomysial IgA Antibody Screen with Reflex to Titer test is typically ordered when a person has symptoms suggestive of celiac disease, including digestive discomfort, diarrhea, weight loss, and fatigue. This test is used to detect the presence of endomysial antibodies, which are often elevated in individuals with celiac disease.
How does the Endomysial IgA Antibody Screen with Reflex to Titer test contribute to the diagnosis of celiac disease?
The Endomysial IgA Antibody Screen with Reflex to Titer test is a valuable tool in diagnosing celiac disease. Elevated levels of endomysial antibodies are highly specific for celiac disease, making this test one of the primary diagnostic tools. If the initial screen is positive, the reflex to titer will quantify the antibody levels, providing more detailed information about the potential severity and activity of the disease.
Interpretation of Results
What do positive results in the Endomysial IgA Antibody Screen with Reflex to Titer test indicate?
A positive result for the Endomysial IgA Antibody Screen with Reflex to Titer test indicates the presence of endomysial antibodies in the blood, which is strongly associated with celiac disease. A subsequent titer will measure the amount of these antibodies, offering insight into the disease's activity.
Can someone have celiac disease with a negative Endomysial IgA Antibody Screen result?
Yes, while a negative result on the Endomysial IgA Antibody Screen decreases the likelihood of celiac disease, it doesn't entirely rule it out. Some individuals, particularly those with selective IgA deficiency, may not produce detectable levels of endomysial antibodies even if they have celiac disease. In such cases, other diagnostic methods, such as tissue transglutaminase (tTG) antibody testing or intestinal biopsy, might be considered.
How do the results of the Endomysial IgA Antibody Screen with Reflex to Titer test influence clinical management?
If a patient has a positive Endomysial IgA Antibody Screen with Reflex to Titer test, it provides strong evidence of celiac disease, prompting healthcare providers to consider a gluten-free diet as part of the management strategy. Additionally, further evaluations, including potential biopsies of the small intestine or consultations with specialists, may be recommended based on the results.
What other tests might be ordered alongside the Endomysial IgA Antibody Screen with Reflex to Titer test?
Alongside the Endomysial IgA Antibody Screen with Reflex to Titer test, healthcare providers might order other tests to get a comprehensive view of potential celiac disease. Common accompanying tests include tissue transglutaminase (tTG) IgA and IgG antibody tests, total serum IgA level, and deamidated gliadin peptide (DGP) antibody tests. In some cases, genetic testing for HLA-DQ2 and HLA-DQ8 might also be considered.
Relationships with Other Health Conditions
Are there other conditions that might produce a positive Endomysial IgA Antibody Screen with Reflex to Titer test result?
While the presence of endomysial antibodies is highly specific to celiac disease, there are rare instances where other conditions might lead to a positive result. Conditions such as dermatitis herpetiformis (a skin condition linked to celiac disease), autoimmune liver diseases, and some connective tissue disorders have been associated with elevated endomysial antibodies.
If someone has been treated for celiac disease and follows a gluten-free diet, will the Endomysial IgA Antibody Screen with Reflex to Titer test still be positive?
In most individuals who have been diagnosed with celiac disease and are adhering to a strict gluten-free diet, endomysial antibody levels typically decrease and may even become undetectable. However, if someone continues to ingest gluten accidentally or is non-compliant with the diet, the test may remain positive. Monitoring antibody levels can be a tool for assessing dietary adherence and the effectiveness of treatment.
We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.