Normal transaminases with high bilirubin, if it is mildly elevated, can be caused by physiologic reasons, and observation is sufficient. It may also be related to biliary system diseases, hemolytic disease, severe hepatitis and so on, is more important. 1. Biliary system diseases: such as cholelithiasis, acute cholecystitis, chronic cholecystitis, intrahepatic bile duct stones and other diseases cause bile stasis, resulting in higher than normal values of bile acids and bilirubin in the blood. 2. Hemolytic disease: common is thalassemia, serous disease, etc., easy to cause hemolytic jaundice, mostly manifested as high total bilirubin, transaminase is normal. It is necessary to improve the blood routine, hemolysis related examination and other clear diagnosis. 3. Severe hepatitis: patients’ aminotransferase has different degree of elevation in the early stage, but with the progress of the disease, the damage of hepatocyte is getting more and more serious, the aminotransferase may drop to normal value, and the bilirubin is gradually increased, which usually suggests that the disease is serious. If the transaminase is normal and the bilirubin is high, it is necessary to take corresponding measures according to the specific cause of the disease, such as medication, life regulation, dietary regulation, etc.
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