REVIEW: Nonalcoholic steatohepatitis

  title={REVIEW: Nonalcoholic steatohepatitis},
  author={Jurgen Ludwig and Douglas B. McGill and Keith D. Lindor},
  journal={Journal of Gastroenterology and Hepatology},
Nonalcoholic steatohepatitis (NASH) is a reasonably well‐defined clinicopathological entity; it has been reported more commonly in women than in men or children of both sexes and it appears to be most closely associated with obesity, diabetes mellitus and related abnormalities, such as hyperlipidaemia and hyperglycaemia. However, the association with female gender, obesity and diabetes may not be as close as suggested by the literature and an underlying condition cannot be discerned in all… 

Alcoholic and nonalcoholic steatohepatitis.

  • E. Brunt
  • Medicine
    Clinics in liver disease
  • 2002

Fatty Liver and Nonalcoholic Steatohepatitis. Where Do We Stand and Where Are We Going?

The clinical significance of FL is incompletely understood at present and the relationship, if any, of FL and the metabolic syndrome should be carefully investigated.

Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions

There are no systems for grading necroinflammatory activity or for staging fibrosis as exist for various other forms of chronic liver disease and this study proposes a grading and staging system that reflects the unique histological features of nonalcoholic steatohepatitis.

Hepatocellular ballooning in nonalcoholic steatohepatitis: the pathologist’s perspective

  • C. Lackner
  • Medicine, Biology
    Expert review of gastroenterology & hepatology
  • 2011
The rearrangement of the intermediate filament cytoskeleton can be demonstrated by the loss of keratin 8/18 immunostaining of the cytoplasm, and may be evaluated in the future as a marker for the more objective detection of hepatocellular ballooning in NASH.

Nonalcoholic steatohepatitis.

  • E. Brunt
  • Medicine
    Seminars in liver disease
  • 2004

LETTER: Nonalcoholic Steatohepatitis-Related Cirrhosis with Subacute Liver Failure: An Autopsy Case

A 76-year-old female who underwent a laparoscopic cholecystectomy because of cholelithiasis at age 71 died of liver failure 4 months from the onset of clinical symptoms, and postmortem examination of the liver showed macrovesicular steatosis, hepatocyte balloons, and inflammation including neutrophils, which are compatible with NASH or an alcoholic liver disease.

The spectrum of nonalcoholic fatty liver disease: from steatosis to nonalcoholic steatohepatitis.

Nonalcoholic fatty liver disease (NAFL) has been recognized only in the past 20 years, and management of weight, lipid levels, and glucose levels is recommended.

Nonalcoholic Fatty liver disease from the perspective of an internist.

  • S. Nair
  • Medicine
    The Ochsner journal
  • 2002
While weight loss remains the most effective treatment, trials with insulin sensitizing agents are underway and there are some animal data as well as preliminary human data showing that metformin might offer some benefit in NAFLD.

Concurrence of Histologic Features of Steatohepatitis with Other Forms of Chronic Liver Disease

The concurrence of clinical and histologic features of steatohepatitis with another chronic liver disease may be a reflection of the frequency of SteatohePatitis in the population at large.



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

Findings in 20 patients with nonalcoholic steatohepatitis of unknown cause found the patients were moderately obese, and many had obesity-associated diseases, such as diabetes mellitus and cholelithiasis.

The natural history of nonalcoholic fatty liver: A follow‐up study

In the absence of preexisting fibrosis or steatohepatitis, fatty liver of nonalcohol‐induced origin is an extremely benign condition.

The natural history of nonalcoholic steatohepatitis: A follow‐up study of forty‐two patients for up to 21 years

In individual patients, poorly controlled diabetes and rapid weight loss preceded the onset of steatohepatitis, and in the patients with extensive fibrosis the the liver disease evolved from one of active inflammation to one of inactive cirrhosis without fat or inflammation.

Nonalcoholic Fatty Hepatitis: An Important Clinical Condition

The roles of alcohol, obesity and type II diabetes are stressed where inhibition of fatty acid oxidation by the liver is the basic defect in metabolism leading to fatty change, balloon degeneration and Mallory body formation.

Fatty liver hepatitis (steatohepatitis) and obesity: An autopsy study with analysis of risk factors

Statohepatitis (fatty liver hepatitis), histologically identical to alcoholic disease, occurs in some obese patients after jejunoileal bypass, and incidence of steatosis and steatohePatitis correlated with the degree of obesity.

Nonalcoholic steatohepatitis in obesity: a reversible condition.

Nonalcoholic steatohepatitis is a rare complication of obesity with laboratory and histological features indistinguishable from alcoholic hepatitis and all responded with normalization of the biochemical and/or histological changes after modest weight reduction.

Ursodeoxycholic acid or clofibrate in the treatment of non‐alcohol‐induced steatohepatitis: A pilot study

Treatment of NASH with UDCA for 12 months resulted in significant improvement in alkaline phosphatase, ALT, GGT, and hepatic steatosis, but despite the known lipid‐lowering effects of clofibrate, it did not appear to be of clinical benefit in the treatment ofNASH in this 1‐year pilot study.