Teenager overcomes autoimmune condition after liver transplant

Medical Mysteries is a series that spotlights rare diseases or unusual conditions.

- Judith Tan

Teenager Ryan Lim slipped into depression after a series of post-transplant infections in 2023.

The Ahmad Ibrahim Secondary School student received a liver transplant on Sept 7, 2023—10 years after he was diagnosed with autoimmune hepatitis (AIH).

It is a rare condition in which the immune system mistakenly attacks the liver, causing chronic inflammation and, in severe cases, liver failure. There are about two to five cases of AIH per 100,000 children worldwide.

Due to his infections, Ryan had to spend more time in the hospital to ensure that his body did not reject his new liver.

The teenager, who was looking forward to returning to school, felt that life had dealt him a harsh blow.

"I thought I could go back to a normal life after the surgery, like any teenager my age. Instead, I had to be in the hospital longer while doctors battled my infections," said Ryan, who is now 17 years old.

He was five when his mother noticed a yellow hue in his skin and the whites of his eyes, and bloating in his abdomen.

"We rushed him to the emergency department of KKH (KK Women's and Children's Hospital), where he underwent tests," said Mrs May Lim, 51, a part-time assistant at a school bookshop.

He was diagnosed with AIH and put on steroids and immunosuppressant medications to stop his immune system from attacking his liver.

"I got tired very easily and could not do things productively. I was also prone to falling sick often," recalled Ryan.

Things took a drastic turn in 2021, when he was starting secondary school and looking forward to making new friends.

Then 13, he was struck by a bout of pancreatitis and was "in and out of hospital" in the first three months of that year, Ryan said. His spleen became inflamed and terribly painful.