Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is the most common disorder seen in pediatric hepatology practice. However, little is known about the clinical, biochemical, and histologic features of the disorder. In addition, there have been no reports of the natural history of NAFLD in the pediatric age group. Methods: Therefore, we retrospectively reviewed the charts of children diagnosed with NAFLD in our institution between January 2000 and March 2007. Results: One hundred six children (82 male and 24 female) were diagnosed with NAFLD. Mean age at diagnosis was 13.4 years (range, 4-18 years). Liver biopsy was done in all patients. Fibrosis was noticed in 6 of 15 patients with normal liver enzymes. Eighteen children had a follow-up liver biopsy during an average period of 28 months. In 8 patients there was no change in fibrosis. Seven patients had progression of fibrosis, whereas 3 patients had regression or disappearance of fibrosis after losing weight. Conclusions: The entire spectrum of histologic features of NAFLD can be seen in children with normal liver enzymes. Rapid progression might be seen in a large proportion of patients and can happen during a short period of time. Larger studies with long duration follow-up are needed to better understand the pathogenesis and the natural history of the disease in the pediatric age group.
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