THE DIAGNOSTIC RELIABILITY OF ANTI-ENDOMYSIAL ANTIBODY IN CELIAC-DISEASE - THE NORTH ISRAEL EXPERIENCE

Assessment of anti-endomysial antibody (EMA) for the diagnosis and fol low-up of celiac disease (CD) is widely accepted, but its applicabilit y has never been investigated in Israel. We therefore investigated EMA as a diagnostic tool in a pediatric population, residing in the north ern part of Israel, with suspected celiac disease. EMA was assessed by an indirect immunofluorescence assay using monkey esophageal sections as a substrate in 22 active CD, 17 non-active CD, and 22 non-CD child ren. EMA titers were correlated with small bowel mucosal pathology. Se nsitivity and specificity of EMA were 100%. EMA levels are diet depend ent, increasing on a gluten-containing diet and decreasing with gluten withdrawal after 3-12 months. EMA is a reliable marker for the diagno sis of CD, and reflects gluten intake changes and patients' dietary co mpliance. In our laboratory, EMA is suitable for the diagnosis and fol low-up of CD.