Out of 19 patients, 14 presented ALI/ALF, including 4 with AIH, 1 with citrin deficiency, 1 with deoxyguanosine kinase (DGOUK) deficiency, 6 with an indeterminate etiology, and 2 with recurrent ALF (RALF). The gene discussed is DGUOK; the disease is hyperinsulinemic hypoglycemia, familial, 4.