Ludwig · Mayo Clinic proceedings 1980 · case series · n=20

Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease.

Cited 2906 times in the scientific literature.

Level 4 - case-series / case-control

Case series of 20 patients without a control group

PubMed 7382552 · record verified 2026-08-26

What was done

Descriptive case series analyzing clinical and histological findings from liver biopsy specimens in 20 nonalcoholic patients evaluated at the Mayo Clinic for unexplained liver disease.

What was found

Biopsy specimens showed striking fatty change, lobular hepatitis, focal necrosis with mixed inflammatory infiltrates, Mallory bodies in most instances, and fibrosis in most specimens, with cirrhosis present in 3 patients. The condition was more common in women, and most patients were moderately obese with associated conditions like diabetes mellitus and cholelithiasis. Hepatomegaly and mild liver function test abnormalities were common.

Why it matters

This landmark paper coined the term nonalcoholic steatohepatitis (NASH) and established it as a distinct clinicopathologic entity capable of progressing to cirrhosis in the absence of alcohol intake.

Limits

Small sample size (n = 20) with no control group from a single medical center. The abstract reports few exact numerical rates or quantitative laboratory values.

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