Index of Severity for Eosinophilic Esophagitis (I-SEE)
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When to use
Symptoms
None
Weekly
Daily
Multiple times per day or disrupting social functioning
Food impaction
None
Food impaction with emergency department visit or endoscopy aged ≥ 18 years)
Food impaction with emergency department visit or endoscopy aged < 18 years)
Hospitalization due to eosinophilic esophagitis
No
Yes
Esophageal perforation
No
Yes
Malnutrition
No
Malnutrition with body mass < 5th percentile or decreased growth trajectory
Inflammation
No
Persistent inflammation requiring elemental formula, or systemic corticosteroid, or immunomodulatory treatments including biologics, azathioprine/6-mercaptopurine, or other immune-targeted treatments)
Endoscopic edema, furrows, and/or exudates
None
Localized
Diffuse
Eosinophil count on esophageal biopsy
Endoscopic rings, strictures
None
Present, but endoscope passes easily
Present, but requires dilation or a snug fit when passing a standard endoscope seen with a 10-14 mm esophagus; esophageal diameter can be measured by balloon-sizing, dilation effect, barium esophagram)
Cannot pass standard upper endoscope; repeated dilations in an adult aged ≥ 18 years); or any dilation in a child aged < 18 years)
Basal zone hyperplasia or laminate propria fibrosis on histology, or dyskeratotic epithelial cell/surface epithelial alteration if no laminate propria
No
Yes
Calculation
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