{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:24:12Z","timestamp":1783358652507,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T00:00:00Z","timestamp":1447977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Nonalcoholic fatty liver disease (<jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>) is associated with obesity and affects roughly 10% of children. However, <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> is often diagnosed by exclusion \u2013 that is, obese children with an elevated alanine aminotransferase (<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>) are screened for <jats:italic>other<\/jats:italic> liver diseases in the absence of a biopsy. This testing is nonstandardized, and professional society recommendations differ. This study examines the yield of testing for disorders <jats:italic>other than <\/jats:italic><jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> in this patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was performed in 120 obese, asymptomatic, noncholestatic children with an <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> \u226540\u00a0U\/L and additional diagnostic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No patients were found to have Wilson's, hepatitis A, hepatitis B, hepatitis C, cytomegalovirus, alpha\u20101 antitrypsin deficiency, autoimmune hepatitis, celiac disease or Epstein\u2013Barr virus. Only one patient (1\/120) was identified with definite disease other than <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>, which was muscular dystrophy. The positive predictive value of a screening test was 5%, and the specificity was 97%. Of 70 children with an abdominal ultrasound, no significant abnormalities were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Extensive testing in asymptomatic, noncholestatic, obese children with an elevated <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> may be of limited diagnostic value and false\u2010positive tests are likely. Large, prospective studies are needed to help focus the work up in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.13176","type":"journal-article","created":{"date-parts":[[2015,9,5]],"date-time":"2015-09-05T07:38:57Z","timestamp":1441438737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Yield of diagnostic tests in obese children with an elevated alanine aminotransferase"],"prefix":"10.1111","volume":"104","author":[{"given":"Bryan","family":"Rudolph","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Children's Hospital at Montefiore Albert Einstein College of Medicine Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Rivas","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition Children's Hospital at Montefiore Albert Einstein College of Medicine Bronx 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