High aminotransferase and normal bilirubin may be caused by toxic hepatitis, viral hepatitis and alcoholic fatty liver disease. 1. Toxic hepatitis: If you find high transaminases and normal bilirubin in liver function test, it may be caused by toxic hepatitis caused by some drugs or chemicals. For example, antibiotic drugs, anti-tuberculosis drugs and other drugs caused by drug liver injury, long-term non-stop medication, may develop into toxic hepatitis. 2. Viral hepatitis: If viral hepatitis leads to liver function damage, liver function test will find high transaminases and normal bilirubin, especially in the viral hepatitis flare-up period is more obvious. 3. Alcoholic fatty liver disease: If alcoholic fatty liver disease leads to accumulation of fat in the liver, it may seriously cause changes in liver function, and transaminases with high bilirubin will also appear normal. If the examination found high transaminases and normal bilirubin, it is recommended to cooperate with the doctor as soon as possible to improve the next step of the examination, to clarify the specific causes, and to take targeted measures to deal with.