Should liver biopsy be performed for repeated high transaminase levels

Whether liver puncture is necessary for repeated high transaminase levels needs to be evaluated based on the cause. In most cases, immediate liver puncture is not necessary, and in rare cases where the cause is unclear or continues to worsen, it may need to be considered. Elevated transaminase levels may be related to factors such as viral hepatitis, fatty liver, and drug-induced liver injury. When transaminase levels are repeatedly elevated, clinical practice usually prioritizes non-invasive methods such as blood tests, ultrasound, or CT to determine the cause. Viral hepatitis can be diagnosed through serological marker testing, fatty liver can be determined through imaging combined with lipid analysis, and drug-induced liver injury requires investigation of medication history. Most patients can identify the cause and receive targeted treatment through the above examinations, such as antiviral therapy, lifestyle adjustments, or discontinuation of hepatotoxic drugs. If routine examinations cannot determine the cause, or if the patient presents with serious symptoms such as jaundice, coagulation dysfunction, or if transaminase levels continue to rise for more than 6 months, the necessity of liver puncture needs to be evaluated. Liver biopsy can distinguish rare causes such as autoimmune hepatitis and genetic metabolic liver disease, but there are risks of bleeding, infection, etc., and strict indications are required.

It is necessary to avoid drinking alcohol in daily life, use hepatotoxic drugs with caution, maintain a low-fat diet, and regularly check liver function. If the cause is clear and the indicators still do not improve after treatment, or if new symptoms such as fatigue and abdominal distension occur, timely follow-up evaluation should be conducted.