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Fifteen-minute consultation: liver disease in children
  1. Jake P Mann1,2,
  2. Kathy Gallagher3,
  3. Emer Fitzpatrick4,
  4. Anil Dhawan4
  1. 1Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
  2. 2Department of Paediatrics, University of Cambridge, Cambridge, UK
  3. 3Department of Paediatrics, Addenbrooke’s Hospital, Cambridge, UK
  4. 4Paediatric Liver, GI and Nutrition Centre and MowatLabs, King’s College London School of Medicine at King’s College Hospital London, London, UK
  1. Correspondence to Dr Jake P Mann, Metabolic Research Laboratories, Level 4, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; jm2032{at}


Liver disease in children can present in many ways from the frequently encountered prolonged neonatal jaundice to the comparatively rare acute liver failure. In this article, we will discuss ‘red flags’ of liver disease, the initial investigations required and when to refer to a specialist liver centre. Across all presentations, the degree of elevation of alanine aminotransferase or aspartate aminotransferase provides only little diagnostic information. Measurement of clotting is vital, and coagulopathy should be followed by a trial of intravenous vitamin K before being repeated.

  • liver function test
  • paedatric
  • nafld
  • biliary atresia
  • acute liver failure

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.