Abstract: Objective The etiology and clinical characteristics of 128 patients with unexplained liver damage were analyzed.Methods From February 2016 to May 2020, 128 patients with unexplained liver dysfunction were selected as the subjects. The etiology was determined by noninvasive examination and liver biopsy combined with pathological results and clinical characteristics.Results According to the pathological results from liver biopsy, there were 115 patients that the causes of liver damage were identified, among them, 56 cases (43.8%) were autoimmune liver disease, 44 cases (34.4%) were nonalcoholic fatty liver disease and 15 cases (11.7%) were drug-induced liver damage, 2 cases (1.6%) were diagnosed with herpesvirus infectious hepatitis by non-hepatitis virus detection and liver histology, 3 cases (2.3%) were diagnosed as Gibert syndrome by gene detection and liver histology. The remaining 8 patients (6.3%) still could not determine the etiology through the above examination.Conclusion In patients with unexplained liver damage, autoimmune liver disease and non-alcoholic fatty liver disease are the main causes, followed by drug-induced liver damage. For patients with abnormal liver function who cannot determine the etiology, special tests such as gene detection or non-hepatitis virus detection can be considered, combined with pathological examination of liver tissue and clinical data of patients for comprehensive analysis, which provides reference for clinical diagnosis and treatment.

Key words: Unexplained liver damage, Liver pathology, Clinical features