Diagnosis relies on the Swansea criteria, which require ≥6 of the following in the absence of another cause: vomiting, encephalopathy, polydipsia/polyuria, abdominal pain, bilirubin >0.8 mg/dL (14 μmol/L), hypoglycemia <72 mg/dL (4 mmol/L), leukocytosis >11,000/μL, spartate transaminase (AST) or alanine aminotransferase (ALT) >42 IU/L, ammonia >47 μmol/L, uric acid >5.7 mg/dL (340 μmol/L), acute kidney injury or creatinine >1.7 mg/dL (150 μmol/L), prothrombin time >14 s, ascites or a bright liver on ultrasound, and microvesicular steatosis on biopsy [4]. The gene discussed is GPT; the disease is steatosis.