MDCalc

Index of Severity for Eosinophilic Esophagitis (I-SEE)

Classifies severity of eosinophilic esophagitis (EoE).

This is one of the first scores created to calculate the disease severity of eosinophilic esophagitis (EoE). You’ll need the patient's history of symptoms, along with their most recent EGD and pathology reports to use this score.

Symptoms and complications

Symptoms

Food impaction

Hospitalization due to EoE

Esophageal perforation

Malnutrition

Inflammation

Immunomodulatory medications can include biologics, azathioprine/6MP, or other immune-targeted treatments.

Inflammatory features

Edema, furrows, and/or exudates

Eosinophil count

The peak eosinophil count should be specifically quantified both for diagnosis and to allow monitoring; however, this tool uses thresholds and ranges.

Fibrostenotic features

Rings, strictures

*Seen with a 10–14 mm esophagus; esophageal diameter can be measured by balloon-sizing, dilation effect, barium esophagram, etc.

BZH or LPF (or DEC/SEA if no LP)

Result:

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Management
  • High scores indicate more severe disease. Work with your patient to track and make diet modifications as necessary, discuss medication therapy if appropriate, and consider esophageal dilation if warranted.
  • For more information regarding diet therapy in EoE, please see this article by Chang et al, 2023.
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