Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner.

Détails

ID Serval
serval:BIB_B2122EEB9D1C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner.
Périodique
Gastroenterology
Auteur(s)
Schoepfer A.M., Safroneeva E., Bussmann C., Kuchen T., Portmann S., Simon H.U., Straumann A.
ISSN
1528-0012 (Electronic)
ISSN-L
0016-5085
Statut éditorial
Publié
Date de publication
2013
Volume
145
Numéro
6
Pages
1230-6.e1-2
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND & AIMS: Development of strictures is a major concern for patients with eosinophilic esophagitis (EoE). At diagnosis, EoE can present with an inflammatory phenotype (characterized by whitish exudates, furrows, and edema), a stricturing phenotype (characterized by rings and stenosis), or a combination of these. Little is known about progression of stricture formation; we evaluated stricture development over time in the absence of treatment and investigated risk factors for stricture formation.
METHODS: We performed a retrospective study using the Swiss EoE Database, collecting data on 200 patients with symptomatic EoE (153 men; mean age at diagnosis, 39 ± 15 years old). Stricture severity was graded based on the degree of difficulty associated with passing of the standard adult endoscope.
RESULTS: The median delay in diagnosis of EoE was 6 years (interquartile range, 2-12 years). With increasing duration of delay in diagnosis, the prevalence of fibrotic features of EoE, based on endoscopy, increased from 46.5% (diagnostic delay, 0-2 years) to 87.5% (diagnostic delay, >20 years; P = .020). Similarly, the prevalence of esophageal strictures increased with duration of diagnostic delay, from 17.2% (diagnostic delay, 0-2 years) to 70.8% (diagnostic delay, >20 years; P < .001). Diagnostic delay was the only risk factor for strictures at the time of EoE diagnosis (odds ratio = 1.08; 95% confidence interval: 1.040-1.122; P < .001).
CONCLUSIONS: The prevalence of esophageal strictures correlates with the duration of untreated disease. These findings indicate the need to minimize delay in diagnosis of EoE.
Pubmed
Web of science
Création de la notice
16/02/2014 12:47
Dernière modification de la notice
20/08/2019 16:20
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