Adults with liver fibrosis can benefit from the noninvasive Enhanced Liver Fibrosis (ELF) score as a diagnostic tool. The ELF score is made up of 3 serum indicators of extracellular matrix remodeling and fibrogenesis: hyaluronic acid (HA), the N-terminal propeptide of collagen type III (PIIINP), and tissue inhibitor of metalloproteinase-1 (TIMP-1). For a study, researchers sought to analyze how the ELF score performed in clinical settings in kids.

Among 343 liver-healthy children aged 6 to 17 were used to construct a reference interval for the ELF score. When comparing healthy children to healthy adults, the median ELF score of 8.9 was substantially higher in youngsters. ELF levels increased dramatically in both female and male healthy controls, peaking during puberty due to increasing levels of HA and PIIINP, which are presumably explained by increased growth. Only 6.4% of the youngsters in the liver-healthy group were in the normal range when adult normal values were used. They examined ELF scores in patients who had probable or confirmed liver fibrosis as a result of autosomal recessive polycystic kidney disease (ARPKD). All ELF values in children with ARPKD fell within the reference intervals calculated from the healthy children group.

The conventional diagnostic cut-off ranges for the ELF score in adults were not relevant in children; instead, age and gender-appropriate cut-off values should be employed. The therapeutic use of ELF scores in children was debatable, as children throughout pubertal development had high ELF levels whereas patients with ARPKD and liver fibrosis had normal values.