APRI With Reflex to NASH FibroSure® Plus
Also known as: Fatty Liver Disease, Liver Fibrosis, NAFLD, NASH, Nonalcoholic Fatty Liver Disease
Use
The cascade is intended for use in patients with non-alcoholic fatty liver disease (NAFLD) and suspected non-alcoholic steatohepatitis (NASH) with advanced fibrosis that include subjects with no alcohol-related disorders and any of the following: elevated liver function tests, obesity, type 2 diabetes, metabolic syndrome, imaging evidence of fat accumulation, dyslipidemia, polycystic ovary syndrome. These patients may be at high risk for progression to advanced liver fibrosis that can cause a fast progression to end-stage liver disease, hepatocellular carcinoma and liver transplantation. Non-invasive blood biomarkers can help identifying those patients using rule-out approach. Liver biopsy is still required to definitively diagnose patients with NASH and NASH fibrosis.
Special Instructions
Patient's age and gender must be submitted. Patient should be fasting for at least eight hours prior to specimen collection. The absence of steatosis with a score of less than 0.41 precludes the diagnosis of NASH/MASH.
Limitations
Clumping can cause falsely low platelet counts, while platelets forming satellites around neutrophils can give a false thrombocytopenia. The test is unsuitable for patients with other liver diseases apart from NAFLD/MASLD, and not recommended in cases of Gilbert disease, acute hemolysis, acute hepatitis, autoimmune hepatitis, extrahepatic cholestasis, transplant patients, or renal insufficiency as these conditions can affect the accuracy of quantitative fibrosis predictions.
Methodology
Other
Biomarkers
LOINC Codes
- 86465-2
- 1920-8
- 777-3
- 86465-2
- 48795-9
- 48794-2
- 93695-5
- 93696-3
- 93692-2
- 93693-0
- 62364-5
- 1835-8
- 4542-7
- 1869-7
- 1975-2
- 2324-2
- 1743-4
- 30239-8
- 2093-3
- 2345-7
- 2571-8
Result Turnaround Time
1-5 days
Related Documents
For more information, please review the documents below
Specimen
Serum
Volume
4.0 mL divided into two tubes, 0.5 for initial testing and 3.5 for possible reflex
Minimum Volume
3.0 mL divided into two tubes, 0.5 for initial testing and 2.5 for possible reflex
Container
Gel-barrier tube or red-top tube
Collection Instructions
Separate from cells within 45 minutes of collection.
Patient Preparation
Patient should be fasting for at least eight hours.
Storage Instructions
Serum sample for initial testing and whole blood can be stored room temperature. Serum sample for possible reflex can be stored refrigerated at 2°C to 8°C for 72 hours.
Causes for Rejection
Gross hemolysis; gross lipemia; improper labeling; nonfasting specimen; patient younger than 14 years of age
Other tests from different labs that may be relevant