Pediatric Fatty Liver and Obesity: Not Always Just a Matter of Non-Alcoholic Fatty Liver Disease

• Main Authors: Renata Alfani, Edoardo Vassallo, Anna Giulia De Anseris, Lucia Nazzaro, Ida d'Acunzo, Carolina Porfito, Claudia Mandato, Pietro Vajro
• Format: Article
• Language: English
• Published: MDPI AG 2018-12-01
• Series: Children
• Subjects: fatty liver; obesity; NAFLD; differential diagnosis; systemic disorders; genetic and metabolic disorders
• Online Access: https://www.mdpi.com/2227-9067/5/12/169

Obesity-related non-alcoholic fatty liver disease (NAFLD) represents the most common cause of pediatric liver disease due to overweight/obesity large-scale epidemics. In clinical practice, diagnosis is usually based on clinical features, blood tests, and liver imaging. Here, we underline the need to make a correct differential diagnosis for a number of genetic, metabolic, gastrointestinal, nutritional, endocrine, muscular, and systemic disorders, and for iatrogenic/viral/autoimmune hepatitis as well. This is all the more important for patients who are not in the NAFLD classical age range and for those for whom a satisfactory response of liver test abnormalities to weight loss after dietary counseling and physical activity measures cannot be obtained or verified due to poor compliance. A correct diagnosis may be life-saving, as some of these conditions which appear similar to NAFLD have a specific therapy. In this study, the characteristics of the main conditions which require consideration are summarized, and a practical diagnostic algorithm is discussed.