Improved method for serological testing in celiac disease - IgA anti-endomysium antibody test: a comparison between monkey oesophagus and human umbilical cord as substrate in indirect immunofluorescence test

The IgA anti-endomysium antibody (IgA-EmA) test has been studied using the indirect immunofluorescence (IF) method with human umbilical cord (HUC) as substrate; 247 sera from patients investigated for celiac disease were tested. The results were in accordance with those obtained using monkey oesophagus (MOE) as substrate. IgA-EmA testing using HUC is shown to have similar reproducibility, sensitivity and specificity as MOE. By avoiding both fixation in chloroform and the blocking step, the processing time for this improved method is decreased by almost 1 h, and the results are stable for reading by fluorescence microscopy for at least 24 h. The indirect IF method using HUC as substrate is easy, reliable and inexpensive. We conclude that the IgA-EmA test using HUC as a substrate can be routinely used for celiac disease screening and follow up.