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Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease

In 2017, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition published clinical practice guidelines for the assessment and diagnosis of nonalcoholic fatty liver disease (NAFLD). We determined how frequently these investigations suggest an alternate etiology for chronic...

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Autores principales: Al-Harthy, Fat’hiya, Kamath, Neha, Hill, Lee, Popov, Jelena, Bossert, Allison, Brill, Herbert, Pai, Nikhil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158344/
https://www.ncbi.nlm.nih.gov/pubmed/37168906
http://dx.doi.org/10.1097/PG9.0000000000000181
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author Al-Harthy, Fat’hiya
Kamath, Neha
Hill, Lee
Popov, Jelena
Bossert, Allison
Brill, Herbert
Pai, Nikhil
author_facet Al-Harthy, Fat’hiya
Kamath, Neha
Hill, Lee
Popov, Jelena
Bossert, Allison
Brill, Herbert
Pai, Nikhil
author_sort Al-Harthy, Fat’hiya
collection PubMed
description In 2017, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition published clinical practice guidelines for the assessment and diagnosis of nonalcoholic fatty liver disease (NAFLD). We determined how frequently these investigations suggest an alternate etiology for chronic hepatitis in 8- to 17-year-old patients with body mass index >85%, elevated alanine aminotransferase and radiographic steatosis, and rates of adherence to 2017 guidelines. METHODS: We conducted a retrospective chart review of patients presenting to McMaster Children’s Hospital from 2017–2020 for evaluation of suspected NAFLD. Bloodwork was reviewed. RESULTS: Ninety-five patients met inclusion criteria. Abnormal bloodwork that required further testing was found in 28.4%; a different chronic liver disease was ultimately diagnosed in 11.6%. Only 9.5% received comprehensive, additional bloodwork for other causes of liver disease. CONCLUSION: A high proportion of patients evaluated for suspected NAFLD had bloodwork possibly suggesting an alternate diagnosis. Comprehensive testing was infrequently performed. These results reinforce the importance of maintaining a differential diagnosis among children presumed to have NAFLD.
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spelling pubmed-101583442023-05-09 Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease Al-Harthy, Fat’hiya Kamath, Neha Hill, Lee Popov, Jelena Bossert, Allison Brill, Herbert Pai, Nikhil JPGN Rep Original Article In 2017, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition published clinical practice guidelines for the assessment and diagnosis of nonalcoholic fatty liver disease (NAFLD). We determined how frequently these investigations suggest an alternate etiology for chronic hepatitis in 8- to 17-year-old patients with body mass index >85%, elevated alanine aminotransferase and radiographic steatosis, and rates of adherence to 2017 guidelines. METHODS: We conducted a retrospective chart review of patients presenting to McMaster Children’s Hospital from 2017–2020 for evaluation of suspected NAFLD. Bloodwork was reviewed. RESULTS: Ninety-five patients met inclusion criteria. Abnormal bloodwork that required further testing was found in 28.4%; a different chronic liver disease was ultimately diagnosed in 11.6%. Only 9.5% received comprehensive, additional bloodwork for other causes of liver disease. CONCLUSION: A high proportion of patients evaluated for suspected NAFLD had bloodwork possibly suggesting an alternate diagnosis. Comprehensive testing was infrequently performed. These results reinforce the importance of maintaining a differential diagnosis among children presumed to have NAFLD. Lippincott Williams & Wilkins, Inc. 2022-03-09 /pmc/articles/PMC10158344/ /pubmed/37168906 http://dx.doi.org/10.1097/PG9.0000000000000181 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Al-Harthy, Fat’hiya
Kamath, Neha
Hill, Lee
Popov, Jelena
Bossert, Allison
Brill, Herbert
Pai, Nikhil
Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title_full Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title_fullStr Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title_full_unstemmed Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title_short Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease
title_sort evaluation of hepatitis in pediatric patients with presumed nonalcoholic fatty liver disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158344/
https://www.ncbi.nlm.nih.gov/pubmed/37168906
http://dx.doi.org/10.1097/PG9.0000000000000181
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