Autoantibody positivity in nonalcoholic fatty liver disease (NAFLD) without autoimmune hepatitis (AIH) is still not clear in terms of its clinical significance. Researchers wanted to find out how common autoantibodies were in a group of children with biopsy-proven NAFLD and see if there was a link between autoantibodies and the severity of NAFLD. From 2014 to 2019, a single-center, retrospective study was done on patients around the same age or younger than 21 with biopsy-proven NAFLD. Within 90 days of the liver biopsy, both clinical and lab data were collected. Serum titers more than equal to 1:80 or units more than equal to 20 were used to define autoantibody positivity. Liver biopsies were looked at for signs of AIH, then scored for steatosis, hepatocyte ballooning, and lobular inflammation, and a NAFLD activity score (NAS) was made. Both inflammation and scarring in the portal were given separate scores. For both continuous and 2-way outcomes, multivariable logistic regression was used. About  67 subjects met the requirements to be included. Positive antinuclear antibody (ANA), antismooth muscle antibody (ASMA), antineutrophil cytoplasmic antibody (ANCA), anti-F-actin antibody (F-actin), or anti-liver kidney microsomal (LKM) antibody was seen in 43%, 39%, 19%, 13%, 0%, and 66% of subjects, respectively. After taking into account other factors that could affect the results, people with a positive ANA and alanine aminotransferase (ALT) more than 80 were 4.6 times more likely to have a NAS more than equal to 5 (P=0.035; 95% CI, 1.12–19.01). Autoantibody positivity went away in 10%–50% of people who were monitored over time. Autoantibodies, other than LKM, were often found in their group of children with NAFLD who did not have AIH. If a child with suspected NAFLD has a positive ANA and ALT, this may help doctors find the ones who are most likely to get nonalcoholic steatohepatitis (NASH).


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