Gluten-sensitive enteropathy (celiac disease) is a painful inflammatory disease of the small intestine that interferes with the absorption of many essential nutrients. It is caused by an autoimmune reaction to gluten (wheat, rye and barley). Several antibodies may be produced during the course of the disease (anti-transglutaminase, anti-gliadin, anti-endomysium). Among these, anti-transglutaminase levels are considered the most useful. Anti-endomysium antibody or deamidated gliadin antibody tests are sometimes used second-line when anti-transglutaminase antibody levels are only slightly positive.
Negative or positive results with a titre below 1:40 are seen in normal individuals. Titres above 1:40 are abnormal. The presence of anti-endomysium antibodies is very specific to celiac disease and dermatitis herpetiformis (a condition that often accompanies celiac disease). Results can also be used to monitor compliance with a gluten-free diet.