{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:58:51Z","timestamp":1780498731843,"version":"3.54.1"},"reference-count":68,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T00:00:00Z","timestamp":1544659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Obesity-related non-alcoholic fatty liver disease (NAFLD) represents the most common cause of pediatric liver disease due to overweight\/obesity large-scale epidemics. In clinical practice, diagnosis is usually based on clinical features, blood tests, and liver imaging. Here, we underline the need to make a correct differential diagnosis for a number of genetic, metabolic, gastrointestinal, nutritional, endocrine, muscular, and systemic disorders, and for iatrogenic\/viral\/autoimmune hepatitis as well. This is all the more important for patients who are not in the NAFLD classical age range and for those for whom a satisfactory response of liver test abnormalities to weight loss after dietary counseling and physical activity measures cannot be obtained or verified due to poor compliance. A correct diagnosis may be life-saving, as some of these conditions which appear similar to NAFLD have a specific therapy. In this study, the characteristics of the main conditions which require consideration are summarized, and a practical diagnostic algorithm is discussed.<\/jats:p>","DOI":"10.3390\/children5120169","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T03:58:17Z","timestamp":1544759897000},"page":"169","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pediatric Fatty Liver and Obesity: Not Always Just a Matter of Non-Alcoholic Fatty Liver Disease"],"prefix":"10.3390","volume":"5","author":[{"given":"Renata","family":"Alfani","sequence":"first","affiliation":[{"name":"Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy"},{"name":"Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Vassallo","sequence":"additional","affiliation":[{"name":"Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy"},{"name":"Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Giulia","family":"De Anseris","sequence":"additional","affiliation":[{"name":"Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D\u2019Aragona, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Nazzaro","sequence":"additional","affiliation":[{"name":"Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D\u2019Aragona, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"D'Acunzo","sequence":"additional","affiliation":[{"name":"Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy"},{"name":"Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Porfito","sequence":"additional","affiliation":[{"name":"Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy"},{"name":"Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2425-5449","authenticated-orcid":false,"given":"Claudia","family":"Mandato","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Santobono-Pausilipon, Department of Pediatrics, 80129 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-5880","authenticated-orcid":false,"given":"Pietro","family":"Vajro","sequence":"additional","affiliation":[{"name":"Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy"},{"name":"Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy"},{"name":"Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D\u2019Aragona, 84131 Salerno, Italy"},{"name":"Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Pediatrics Section, University of Salerno, 84081 Baronissi (Salerno), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,13]]},"reference":[{"key":"ref_1","unstructured":"Hales, C.M., Carroll, M.D., Fryar, C.D., and Ogden, C.L. 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