Common clinical causes of high serum cholinesterase include liver disease, metabolic disease, anemia and so on. 1. Liver diseases: Liver function damage in patients with viral hepatitis, cirrhosis, hepatocellular carcinoma and other diseases can lead to high serum cholinesterase. 2. Metabolic diseases: metabolic diseases such as hyperthyroidism and diabetes mellitus, increased fat metabolism can lead to increased synthesis of acetylcholine, which in turn leads to high serum cholinesterase. 3. anemia: hemolytic anemia, megaloblastic anemia and other diseases, when the destruction of red blood cells will release acetylcholinesterase, will also lead to high serum cholinesterase. There may be other reasons for high serum cholinesterase, and it is recommended that patients with persistently high serum cholinesterase should go to the hospital as soon as possible to get a clear picture of the cause of the disease.