Assessment of anti-endomysial antibody (EMA) for the diagnosis and follow-up of celiac disease (CD) is widely accepted, but its applicability has never been investigated in Israel. We therefore investigated EMA as a diagnostic tool in a pediatric population, residing in the northern 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 children. EMA titers were correlated with small bowel mucosal pathology. Sensitivity and specificity of EMA were 100%. EMA levels are diet dependent, increasing on a gluten-containing diet and decreasing with gluten withdrawal after 3-12 months. EMA is a reliable marker for the diagnosis of CD, and reflects gluten intake changes and patients' dietary compliance. In our laboratory, EMA is suitable for the diagnosis and follow-up of CD.
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