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Acute hepatitis may result from acute infection, prescribed or other drugs, ischaemia or vascular causes, autoimmune hepatitis, or idiopathic liver failure. Non\u2010alcoholic fatty liver disease is now the most likely reason for abnormal liver function tests but medications, metabolic disease, cholangiopathy and non\u2010liver causes should be considered. Autoimmune hepatitis and alpha\u20101\u2010antitrypsin deficiency are the most likely causes of insidious liver disease. An international normalised ratio uncorrected by vitamin K reflects the severity of liver synthetic dysfunction, but not propensity to bleed. Creatine kinase helps to differentiate muscle from liver disease in patients with raised transaminases. Doppler ultrasound of hepatic vasculature is useful when assessing splenomegaly to differentiate extra\u2010hepatic portal hypertension from inherent liver disease.<\/jats:p>","DOI":"10.1111\/jpc.14708","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:35:13Z","timestamp":1605573313000},"page":"1702-1707","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Liver disease in the older child"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7532-0541","authenticated-orcid":false,"given":"Looi C","family":"Ee","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Liver Transplant Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2010.09.002"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000100046.06009.b0"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(98)70479-2"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(97)70359-7"},{"key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1038\/ajg.2016.556","article-title":"On the brink of death: Managing acute liver failure","volume":"112","author":"Maheswari R","year":"2017","journal-title":"Am. 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