Endomysial Antibody (IgA) Screen with Reflex to Titer - The presence of anti-endomysial (EMA) IgA antibodies has been shown to correlate with gluten-sensitive enteropathy such as celiac disease (CD) and dermatitis herpetiformis (DH). EMA is detected primarily by IFA, using monkey esophagus as a substrate and observing fluorescence of the endomysial lining. Patients with CD and DH can also demonstrate antibodies to reticulin and gliadin, though EMA-IgA seems to be the most specific marker (specifically 94-100%).