目标:最近开发了EoE严重程度指数(I-SEE)。我们旨在了解儿童纵向队列中的I-SEE评分,并确定I-SEE与儿童临床特征之间的关系。
方法:我们对作为常规临床护理一部分的单中心儿童前瞻性队列进行了回顾性分析。在平均6.6年的诊断和随访内窥镜检查中计算I-SEE。非活动评分为0,1-6表示轻度,中度为7-14,重度EoE为≥15。我们分析了临床,内窥镜,和组织学特征。在基线分析症状,第一次跟进,最后一次内窥镜检查。
结果:在至少2年的随访时间内,67名符合至少3次内窥镜检查研究标准的儿童中,43%,36%,21%的人患有轻度疾病,中度,基线时严重的I-SEE评分,分别。在第一次和第二次内窥镜检查之间,该组平均I-SEE从9.7±7.2降至6.1±5.9(p<0.001)。在最后一个实例中,整体I-SEE评分降至3.9(p<0.001)。BMI小于5%和喂养不良在基线时I-SEE评分严重的儿童中更为常见,并且在最后一次情况下都有所改善。最后一次活检可改善纤维化(p<0.01)。
结论:I-SEE是常规临床治疗中长期治疗的儿童的反应性严重程度指标。基线低BMI和不良喂养在I-SEE评分严重的儿童中更为常见。
OBJECTIVE: The Index of Severity for Eosinophilic Esophagitis (I-SEE) was recently developed. We aimed to understand I-SEE scores in a longitudinal pediatric cohort and to determine the relationship between I-SEE and clinical features in children.
METHODS: We performed a retrospective analysis on a prospectively enrolled cohort of children at a single center who were treated as part of routine clinical care. I-SEE was calculated at the diagnostic and follow-up endoscopies over a mean of 6.6 years. Scoring was 0 for inactive, 1-6 for mild, 7-14 for moderate, and ≥15 for severe eosinophilic esophagitis (EoE). We analyzed clinical, endoscopic, and histologic features at each instance. Symptoms were analyzed at the baseline, first follow-up, and last endoscopic instance.
RESULTS: Of 67 children who met study criteria of at least 3 endoscopies over at least 2 years of follow-up time, 43%, 36%, and 21% had mild, moderate, and severe I-SEE scores at baseline, respectively. Between the first and second endoscopic instances, there was a decrease in the group mean I-SEE from 9.7 ± 7.2 to 6.1 ± 5.9 (P < .001). By the last instance, the overall I-SEE score dropped to 3.9 (P < .001). Body mass index <5% and poor feeding were more common in the children with severe I-SEE scores at baseline, and both improved by the last instance. Fibrosis was improved by the last instance biopsy (P < .01).
CONCLUSIONS: I-SEE is a responsive severity metric in children treated long term during routine clinical care. Baseline low body mass index and poor feeding were more common in children with severe I-SEE scores.