Sorted By Test Name - Mayo Medical Laboratories

EGPL
82704
patients with dermatitis herpetiformis or celiac disease, and in nearly all such patients who have high
grade gluten-sensitive enteropathy and are not adhering to a gluten-free diet. For your convenience, we
recommend utilizing cascade testing 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. Algorithms for the cascade tests are available in Special Instructions. -CDCOM/89201
Celiac Disease Comprehensive Cascade: complete testing including HLA DQ -CDSP/89199 Celiac
Disease Serology Cascade: complete testing excluding HLA DQ -CDGF/89200 Celiac Disease
Comprehensive Cascade for Patients on a Gluten-Free Diet: for patients already adhering to a gluten-free
diet To order individual tests, see Celiac Disease Diagnostic Testing Algorithm in Special Instructions.
Useful For: Diagnosis of dermatitis herpetiformis and celiac disease Monitoring adherance to
gluten-free diet in patients with dermatitis herpetiformis and celiac disease Because of the high specificity
of endomysial antibodies for celiac disease, the test may obviate the need for multiple small bowel
biopsies to verify the diagnosis. This may be particularly advantageous in the pediatric population,
including the evaluation of children with failure to thrive.
Interpretation: The finding of IgA-endomysial antibodies (EMA) is highly specific for dermatitis
herpetiformis or celiac disease. The titer of IgA-EMA generally correlates with the severity of
gluten-sensitive enteropathy. If patients strictly adhere to a gluten-free diet, the titer of IgA-EMA should
begin to decrease within 6 to 12 months of onset of dietary therapy. Occasionally, the staining results
cannot be reliably interpreted as positive or negative because of strong smooth muscle staining, weak
EMA staining or other factors; in this case, the results will be recorded as "indeterminate." In this setting,
further testing with measurement of TTGA/82587 Tissue Transglutaminase (tTG) Antibody, IgA, Serum
and IGA/8157 Immunoglobulin A (IgA), Serum levels are recommended.
Reference Values:
Report includes presence and titer of circulating IgA endomysial antibodies.
Negative in normal individuals; also negative in dermatitis herpetiformis or celiac disease patients
adhering to gluten-free diet. See Results of IF Testing* in Cutaneous Immunofluorescence Testing in
Special Instructions.
Clinical References: 1. Peters MS, McEvoy MT: IgA antiendomysial antibodies in dermatitis
herpetiformis. J Am Acad Dermatol 1989;21:1225-1231 2. Chorzelski TP, Buetner EH, Sulej J, et al: IgA
anti-endomysium antibody: a new immunological marker of dermatitis herpetiformis and coeliac disease.
Br J Dermatol 1984;111:395-402 3. Kapuscinska A, Zalewski T, Chorzelski TP, et al: Disease specificity
and dynamics of changes in IgA class anti-endomysial antibodies in celiac disease. J Pediatr Gastroenterol
Nutr1984;6:529-534
English Plantain, IgE
Clinical Information: Clinical manifestations of immediate hypersensitivity (allergic) diseases are
caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from
immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE
antibodies interact with allergen. In vitro serum testing for IgE antibodies provides an indication of the
immune response to allergen(s) that may be associated with allergic disease. The allergens chosen for
testing often depend upon the age of the patient, history of allergen exposure, season of the year, and
clinical manifestations. In individuals predisposed to develop allergic disease(s), the sequence of
sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and
bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat
proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to
sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Useful For: Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease
and to define the allergens responsible for eliciting signs and symptoms. Testing also may be useful to
identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm
sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of
allergic reactions to insect venom allergens, drugs, or chemical allergens.
Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 669