A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions

被引：9

作者：

Dellon, Evan S. ^{[1
]}

Khoury, Paneez ^{[2
]}

Muir, Amanda B. ^{[3
,4
]}

Liacouras, Chris A. ^{[3
,4
,5
]}

Safroneeva, Ekaterina ^{[6
]}

Atkins, Dan ^{[7
,8
]}

Collins, Margaret H. ^{[9
,10
]}

Gonsalves, Nirmala ^{[11
]}

Falk, Gary W. ^{[4
,12
]}

Spergel, Jonathan M. ^{[4
,13
]}

Hirano, Ikuo ^{[11
]}

Chehade, Mirna ^{[14
]}

Schoepfer, Alain M. ^{[15
,16
]}

Menard-Katcher, Calies ^{[17
,18
]}

Katzka, David A. ^{[19
]}

Bonis, Peter A. ^{[20
]}

Bredenoord, Albert J. ^{[21
]}

Geng, Bob ^{[22
,23
]}

Jensen, Elizabeth T. ^{[24
]}

Pesek, Robert D. ^{[25
,26
]}

Feuerstadt, Paul ^{[27
,28
]}

Gupta, Sandeep K. ^{[29
,30
,31
]}

Lucendo, Alfredo J. ^{[32
,33
,34
]}

Genta, Robert M. ^{[35
]}

Hiremath, Girish ^{[36
]}

McGowan, Emily C. ^{[37
]}

Moawad, Fouad J. ^{[38
]}

Peterson, Kathryn A. ^{[39
]}

Rothenberg, Marc E. ^{[40
,41
]}

Straumann, Alex ^{[42
]}

Furuta, Glenn T. ^{[18
,43
,44
]}

Aceves, Seema S. ^{[23
,45
]}

机构：

[1] Univ N Carolina, Ctr Esophageal Dis & Swallowing, Div Gastroenterol & Hepatol, Sch Med, CB 7080,Bioinformat Bldg,130 Mason Farm Rd, Chapel Hill, NC 27516 USA

[2] NIAID, Human Eosinophil Sect, Lab Parasit Dis, 9000 Rockville Pike, Bethesda, MD 20892 USA

[3] Univ Penn, Perelman Sch Med, Div Gastroenterol Hepatol & Nutr, Philadelphia, PA 19104 USA

[4] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[5] Univ Penn, Perelman Sch Med, Ctr Pediat Eosinophil Disorders, Philadelphia, PA 19104 USA

[6] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland

[7] Univ Colorado, Sch Med, Gastrointestinal Eosinophil Dis Program, Aurora, CO USA

[8] Childrens Hosp Colorado, Aurora, CO USA

[9] Univ Cincinnati, Coll Med, Dept Pathol & Lab Med, Cincinnati, OH USA

[10] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA

[11] Northwestern Univ, Feinberg Sch Med, Gastroenterol & Hepatol, Chicago, IL 60611 USA

[12] Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA

[13] Univ Penn, Dept Pediat, Perelman Sch Med, Philadelphia, PA 19104 USA

[14] Icahn Sch Med Mt Sinai, Mt Sinai Ctr Eosinophil Disorders, New York, NY 10029 USA

[15] CHU Vaudois, Lausanne, Switzerland

[16] Univ Lausanne, Lausanne, Switzerland

[17] Univ Colorado, Sch Med, Dept Pediat, Aurora, CO USA

[18] Childrens Hosp Colorado, Digest Hlth Inst, Aurora, CO USA

[19] Mayo Clin, Rochester, NY USA

[20] Tufts Med Ctr, Boston, MA 02111 USA

[21] Amsterdam Univ Med Ctr, Dept Gastroenterol, Amsterdam, Netherlands

[22] Univ Calif San Diego, San Diego, CA 92103 USA

[23] Rady Childrens Hosp, San Diego, CA USA

[24] Wake Forest Sch Med, Epidemiol & Prevent, Winston Salem, NC 27101 USA

[25] Univ Arkansas Med Sci, Div Allergy Immunol, Little Rock, AR 72205 USA

[26] Arkansas Childrens Hosp, 800 Marshall St, Little Rock, AR 72202 USA

[27] Yale New Haven Hosp, Div Gastroenterol, 20 York St, New Haven, CT 06504 USA

[28] Gastroenterol Ctr, Phys Alliance Connecticut, Hamden, CT USA

[29] Indiana Univ Sch Med, Sect Pediat Gastroenterol Hepatol Nutr, Indianapolis, IN 46202 USA

[30] Riley Hosp Children, Indianapolis, IN USA

[31] Community Hlth Network, Indianapolis, IN USA

[32] Hosp Gen Tomelloso, Dept Gastroenterol, Ciudad Real, Spain

[33] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

[34] Inst Invest Sanitaria La Princesa, Madrid, Spain

[35] Baylor Coll Med, Houston, TX 77030 USA

[36] Monroe Carell Jr Childrens Hosp Vanderbilt, Dept Pediat, Nashville, TN USA

[37] Univ Virginia, Allergy & Clin Immunol, Charlottesville, VA USA

[38] Scripps Clin, Div Gastroenterol, La Jolla, CA USA

[39] Univ Utah Hlth, Div Gastroenterol, Salt Lake City, UT USA

[40] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Allergy & Immunol, Cincinnati, OH 45229 USA

[41] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA

[42] Univ Hosp Zurich, Zurich, Switzerland

[43] Univ Colorado, Sch Med, Dept Pediat, Gastrointestinal Eosinophil Dis Program, Aurora, CO USA

[44] Univ Colorado, Sch Med, Mucosal Inflammat Program, Aurora, CO USA

[45] Univ Calif San Diego, Div Allergy Immunol, San Diego, CA 92103 USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2022年 / 150卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Eosinophilic esophagitis; severity; complications; symptoms; endoscopy; histology; ENDOSCOPIC REFERENCE SCORE; JOINT TASK-FORCE; HISTOLOGIC REMISSION; DISEASE-ACTIVITY; MODEST ACCURACY; ADULT PATIENTS; AGA INSTITUTE; MANAGEMENT; DIAGNOSIS; VALIDATION;

D O I：

10.1016/j.jaci.2022.03.015

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background & Aims: Disease activity and severity of eosinophilic esophagitis (EoE) dictate therapeutic options and management, but the decision-making process for determining severity varies among practitioners. To reduce variability in practice patterns and help clinicians monitor the clinical course of the disease in an office setting, we aimed to create an international consensus severity scoring index for EoE. Methods: A multidisciplinary international group of adult and pediatric EoE researchers and clinicians, as well as non-EoE allergy immunology and gastroenterology experts, formed 3 teams to review the existing literature on histology, endoscopy, and symptoms of EoE in the context of progression and severity. A steering committee convened a 1-day virtual meeting to reach consensus on each team's opinion on salient features of severity across key clinicopathologic domains and distill features that would allow providers to categorize disease severity. Results: Symptom features and complications and inflammatory and fibrostenotic features on both endoscopic and histologic examination were collated into a simplified scoring system-the Index of Severity for Eosinophilic Esophagitis (I-SEE)-that can be completed at routine clinic visits to assess disease severity using a point scale of 0-6 for mild, 7-14 for moderate, and >= 15 for severe EoE. Conclusions: A multidisciplinary team of experts iteratively created a clinically usable EoE severity scoring system denominated "I-SEE'' to guide practitioners in EoE management by standardizing disease components reflecting disease severity beyond eosinophil counts. I-SEE should be validated and refined using data from future clinical trials and routine clinical practice to increase its utilization and functionality.

引用

页码：33 / 47

页数：15

共 110 条

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