is an extracellular matrix (ECM) marker set consisting of tissue inhibitor of metalloproteinases 1 (TIMP-1), amino-terminal propeptide of type III procollagen (PIIINP) and hyaluronic acid (HA) showing good correlations with fibrosis stages in chronic liver disease
the ELF score combines quantitative serum concentration measurements of three fibrosis markers (TIMP-1, PIIINP, and HA) to a single value
NICE suggest that:
consider using the enhanced liver fibrosis (ELF) test in people who have been diagnosed with non-alcoholic fatty liver disease (NAFLD) to test for advanced liver fibrosis
do not use routine liver blood tests to assess for advanced liver fibrosis in people with NAFLD
diagnose people with advanced liver fibrosis if they have:
an ELF score of 10.51 or above
and NAFLD
refer adults and young people diagnosed with advanced liver fibrosis to a relevant specialist in hepatology
explain to people with an ELF score below 10.51 that:
they are unlikely to have advanced liver fibrosis
and reassessment for advanced liver fibrosis every 3 years for adults and every 2 years for children and young people is sufficient for regular monitoring
and no interim tests are needed
offer retesting for advanced liver fibrosis for people with an ELF score below 10.51:
every 3 years to adults
every 2 years to children and young people
consider using ELF for retesting people with advanced liver fibrosis
Notes:
liver fibrogenesis represents the uniform response of the liver to toxic, infectious, or metabolic agents and is characterized by an increased synthesis and altered deposition of newly formed extracellular matrix (ECM) components
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