Endomysial antibody (EMA) test
Quick answer: This test looks for endomysial antibodies, which are very specific to coeliac disease. It is used to help diagnose coeliac disease, often to confirm a positive tTG antibody test.
- SampleBlood
- TakesAbout 5 minutes
- Before the testKeep eating your usual diet with gluten before the test unless your doctor advises otherwise.
How the test is done
- 1You keep eating gluten as usual before the test
- 2Blood is drawn from your arm
- 3The lab tests your serum on tissue slides under a fluorescent microscope
- 4The result is reported as positive or negative, sometimes with a titre
What your results can mean
Reading your report
A positive result strongly suggests coeliac disease, and your doctor may advise a biopsy to confirm.
If the result is outside the usual range
A positive result is strongly linked with coeliac disease. A negative result makes coeliac disease less likely, but can occur with IgA deficiency or a gluten-free diet.
Who usually has this test
People with a positive tTG-IgA, or with symptoms of coeliac disease such as diarrhoea, weight loss or iron deficiency.
Risks and aftercare
Bruising is possible; stay on your usual diet until your doctor has reviewed the result.
Names and options
Also called: EMA, anti-endomysial antibody, coeliac test
Listed by the hospital as
- ENDOMYSIAL ANTIBODIES, SERUM
Questions about this test
How is EMA different from tTG-IgA?
tTG-IgA is usually the first test, and EMA is often used to confirm a positive result. EMA is very specific but needs skilled reading under a microscope.
Do I need a biopsy if EMA is positive?
Many adults still need a small bowel biopsy to confirm coeliac disease. In some children with very high tTG and positive EMA, guidelines allow diagnosis without a biopsy.
Can EMA be negative if I have IgA deficiency?
Yes, EMA is usually an IgA test, so it can be falsely negative if your body makes little IgA. Labs often check total IgA as well.
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This page explains each test in general terms so you know what to expect. It is not medical advice: your doctor decides which tests you need and what your results mean. Reference ranges differ between laboratories. Updated 4 November 2026.