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At 16, Elizabeth didn't feel sick — yet she was diagnosed with a chronic disease. Across KKH and SGH, SingHealth's teams work together to manage it with her for a lifetime
When Elizabeth (not her real name) was 16, she did not think she had a liver problem. She had visited a SingHealth Polyclinic for abdominal cramps and irregular periods. Instead, she was referred to KK Women's and Children's Hospital (KKH) for further evaluation, where scans and blood tests revealed excess fat in her liver and ALT levels three times above normal.
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Elizabeth was diagnosed with metabolic associated steatotic liver disease (MASLD), a chronic condition in which excess fat builds up in the liver due to metabolic factors — not alcohol use. In early stages, MASLD rarely causes symptoms, but can progress to liver inflammation, scarring, and failure if unmanaged.
Rising childhood obesity has driven a 14-fold increase in paediatric MASLD at KKH since 2003. Most children show no symptoms, and the condition is often discovered incidentally.
“Families meet the new doctor while still within the institution that has cared for them for years.”
“MASLD sits within a broader metabolic and behavioural context, and that often involves the entire family,” says Dr Chiou Fang Kuan, Senior Consultant at KKH. Elizabeth's care involved paediatricians, hepatologists, endocrinologists, a dietitian, and an exercise physiologist. By the end of her first year, her liver health had improved.
Even in her mid-teens, conversations about future care had begun. KKH's Paediatric Onset Liver Disease transition programme prepares adolescents for adult care at Singapore General Hospital (SGH), guiding patients from around age 15 to take ownership of their condition. At 18, Elizabeth met her future adult hepatologist alongside her KKH team, with her full history already shared across SingHealth's electronic medical records.
This article was first published on 8 July 2026.
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Adulthood brought new challenges — night shifts led to missed appointments. Rather than discharging her, the team adjusted her schedule. Today, Elizabeth is 25, her condition stable, and she reaches out early when issues arise. Her journey illustrates what managing MASLD truly requires: not a single intervention, but a system designed to evolve with the patient over decades.
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