Factors Contributing to Delay in Diagnosis of Eosinophilic Gastritis and Duodenitis

Model of stomach, blood test and stethoscope lying next to written title on paper diagnosis Duodenitis. Concept photo of causes, diagnostic, treatment and prevention of disease of Duodenitis
A longitudinal, retrospective cohort study was conducted to determine potential factors contributing to delays in diagnosis of eosinophilic gastritis and/or eosinophilic duodenitis.

Patients with eosinophilic gastritis and/or eosinophilic duodenitis (EG/EoD) have a challenging journey to diagnosis with a mean diagnostic delay of 3.6 years, according to the results of a study published in The Journal of Allergy and Clinical Immunology: In Practice.

A group of investigators from the Mount Sinai Center for Eosinophilic Disorders conducted a longitudinal retrospective cohort study in the United States that involved 4108 patients (2534 adults, 404 adolescents, 1170 children) diagnosed with EG/EoD between the years of 2008 and 2018 who were identified via an administrative claims database. Female participants represented 71% of the adults, 57% of the adolescents, and 37% of the children in the study population. The objective of the study was to measure the length of time from initial symptom indication to EG/EoD diagnosis in the US population and determine possible factors contributing to the delay in diagnosis. Results were obtained by examining patient medical claim history for events associated with the diagnosis.

The investigators discovered that contributing factors for diagnostic delay in US patients with EG/EoD were delayed referral to a gastroenterologist, delayed esophagogastroduodenoscopy, and lack of biopsy collection and/or histopathologic evaluation. Nearly half (44.3%) of patients presenting with nonspecific symptoms were diagnosed with another gastrointestinal condition before a diagnosis of EG/EoD was made. The researchers found that adults experienced a longer diagnostic delay at 48.6 months compared with 33.9 months for adolescents and 36.4 months for children.

Although the study was limited by claims data that might not include the full spectrum of treatment and lack of standardized terminology and diagnostic information for EG/EoD at the present time, the researchers determined that patients with EG/EoD experienced a substantial delay in diagnosis. The authors concluded, “We hope that these findings, together with heightened awareness and standardization of diagnostic guidelines, will improve the diagnostic journey of EG/EoD patients.”

Disclosures: Some authors have declared affiliations with, received funding from, or are employed by the pharmaceutical industry, and this study was sponsored and funded by Allakos, Inc. Please refer to the original study for a full list of disclosures.

Follow @Gastro_Advisor


Chehade M, Kamboj AP, Atkins D, Gehman LT. Diagnostic delay in patients with eosinophilic gastritis and/or duodenitis: a population-based study. J Allergy Clin Immunol Pract. Published online January 21, 2021.  doi:10.1016/j.jaip.2020.12.054