The recognition of a pattern of steatotic liver injury where histology mimicked alcoholic liver disease, but alcohol consumption was denied, led to the identification of non-alcoholic fatty liver disease (NAFLD). Non-alcoholic fatty liver disease has since become the most common chronic liver disease in adults owing to the global epidemic of obesity. However, in paediatrics, the term NAFLD seems incongruous: alcohol consumption is largely not a factor and inherited metabolic disorders can mimic or co-exist with a diagnosis of NAFLD. The term paediatric fatty liver disease may be more appropriate. In this article, we summarise the known causes of steatosis in children according to their typical, clinical presentation: i) acute liver failure; ii) neonatal or infantile jaundice; iii) hepatomegaly, splenomegaly or hepatosplenomegaly; iv) developmental delay/psychomotor retardation and perhaps most commonly; v) the asymptomatic child with incidental discovery of abnormal liver enzymes. We offer this model as a means to provide pathophysiological insights and an approach to management of the ever more complex subject of fatty liver.

中文翻译：

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小儿脂肪肝 (PeFLD)：并非 NAFLD - 病理生理学见解和管理方法

对脂肪肝损伤模式的识别，其中组织学类似于酒精性肝病，但拒绝饮酒，导致对非酒精性脂肪性肝病 (NAFLD) 的鉴定。由于肥胖的全球流行，非酒精性脂肪肝已成为成人中最常见的慢性肝病。然而，在儿科中，NAFLD 一词似乎不协调：饮酒在很大程度上不是一个因素，遗传性代谢紊乱可以模拟或与 NAFLD 的诊断共存。小儿脂肪肝这个术语可能更合适。在本文中，我们根据儿童典型的临床表现总结了儿童脂肪变性的已知原因：i) 急性肝功能衰竭；ii) 新生儿或婴儿黄疸；iii) 肝肿大、脾肿大或肝脾肿大；iv) 发育迟缓/精神运动迟缓，也许是最常见的；v) 偶然发现肝酶异常的无症状儿童。我们提供该模型作为提供病理生理学见解和管理日益复杂的脂肪肝主题的方法的一种手段。