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Abstract Details
Challenges in Screening for Pediatric Nonalcoholic Fatty Liver Disease
Ferguson AE1, Xanthakos SA1, Siegel RM1. Clin Pediatr (Phila). 2017 Oct 1:9922817733300. doi: 10.1177/0009922817733300. [Epub ahead of print]
Author information
1
1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated liver enzymes in children in the United States. Screening for NAFLD in children with obesity is recommended by several published guidelines, but the application of these recommendations in pediatric weight management programs is uncertain. Our study aimed to describe the screening practices for NAFLD in a large pediatric weight management program. During 2014, 1312 patients were seen, with a liver enzyme panel obtained in 847 (64.5%). Only 47/847 (5.5%) had elevated liver enzymes twice the upper limit of normal. Of the 47, 33 (70%) patients had persistently elevated liver enzymes. Of those 33, 22 (67%) had further exclusionary laboratory testing. Screening for NAFLD is challenging even in a pediatric weight management program with clearly established protocols. Those with elevated liver enzymes do not always complete recommended exclusionary testing. Barriers to completing further evaluation need to be addressed.