Antibody profile in coeliac disease, IgA/IgG: antibodies to endomysium (EMA) and gliadin (GAF-3X)
3 days 
Available with home visit Please note that independent interpretation of test results is not permitted; the information below is provided for informational purposes only.
The Celiac Disease Antibody Profile IgA/IgG is an extended serological investigation of antibodies associated with celiac disease. The profile includes the determination of anti-endomysium antibodies (EMA) and anti-GAF-3X antibodies — a recombinant gliadin analogue containing deamidated epitopes that are important for the immune response in celiac disease.
EMA IgA is a highly specific serological marker for celiac disease and is primarily used to clarify or confirm the results of serological investigations. EMA IgG may serve as an additional marker, particularly in patients with IgA deficiency, in whom IgA antibody tests may produce false-negative results.
Anti-GAF-3X IgA/IgG antibodies reflect the immune response to deamidated gliadin epitopes and complement the serological evaluation when celiac disease is suspected. IgG markers are particularly important in patients with IgA deficiency.
The profile may be used to identify an immune response associated with celiac disease, clarify unclear or contradictory previous serological results, and provide an extended evaluation of patients with symptoms or conditions associated with an increased risk of celiac disease.
Indications
The test may be recommended in cases of:
- chronic or recurrent diarrhea;
- recurrent abdominal pain and bloating;
- unexplained weight loss;
- iron deficiency or anemia of unclear origin;
- unexplained vitamin B12 or folate deficiency;
- delayed growth or development in children;
- persistent unexplained fatigue;
- osteopenia, osteoporosis, or low-trauma fractures;
- dermatitis herpetiformis;
- recurrent aphthous lesions of the oral cavity;
- persistent unexplained elevation of liver transaminases;
- unexplained ataxia or peripheral neuropathy;
- unexplained infertility or recurrent pregnancy loss.
Testing may also be relevant for patients belonging to high-risk groups, including first-degree relatives of patients with celiac disease, patients with type 1 diabetes mellitus, autoimmune thyroid diseases, selective IgA deficiency, Down syndrome or Turner syndrome, autoimmune hepatitis, primary biliary cholangitis, and other autoimmune diseases when corresponding clinical signs are present.
Procedure
The test requires a venous blood sample. Blood is usually collected from a vein in the antecubital area and the procedure takes a few minutes.
The profile includes the determination of anti-endomysium and anti-GAF-3X antibodies of the IgA and IgG classes, providing an extended serological evaluation when celiac disease is suspected.
The test should be performed while consuming gluten, unless otherwise recommended by a physician.
Sources:
https://pubmed.ncbi.nlm.nih.gov/41831197/
https://www.espghan.org/knowledge-center/publications/Gastroenterology/2019_ESPGHAN_guidelines_for_diagnosing_coeliac_disease
https://www.nice.org.uk/guidance/ng20
https://www.euroimmun.com/products/autoimmunity/pd/gastroenterology/zoeliakie-1/3011/6/174182/
Preparation:
For accurate serological diagnosis, the patient should continue consuming gluten-containing foods until the diagnostic evaluation has been completed.
A gluten-free diet should not be initiated independently before the diagnosis is confirmed, as restricting gluten intake may lead to a decrease in antibody concentrations and false-negative results.
If the patient is already following a gluten-free diet or has significantly restricted gluten intake, this should be reported to the physician. The need for and regimen of gluten reintroduction should be determined by a physician.
Additionally, it is recommended to maintain the usual fluid intake, not to discontinue medications without medical advice, and to inform the physician or laboratory about medications being taken, the presence of autoimmune diseases, and adherence to a gluten-free diet.
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