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recipient and the smaller lobe to a pediatric recipient. Several medications are utilized in the management of liver transplantation to prevent or reduce graft rejection. Patients commonly develop T-cell mediated rejection within 6 weeks of transplantation that requires immediate immunosuppression. Calcineurin inhibitors, like cyclosporin and tacrolimus, decrease the risk of graft rejection significantly and improve survivability with rejection risks as low as 5% in adult patients. However, rejection rates can approach 16% in the pediatric population. 7 Other

Dapsone is a leprostatic agent commonly prescribed for the management of leprosy, malaria, and the immunosuppression-induced infections of Pneumocystis carinii and Toxoplasma gondii . In susceptible patients, methemoglobinemia, a potentially life-threatening event, can occur. We report a case of dapsone-induced methemoglobinemia which was observed during general anesthesia for the management of a fractured mandible. CASE REPORT A 56-year-old Asian woman presented for the treatment of a fracture of the body of

into account in the management of patients who are on long-term exogenous steroid therapy. Glucocorticoids are anti-inflammatory agents and have significant immunosuppressive effects. At physiologic levels, the effects of glucocorticoids help to regulate inflammation and maintain homeostasis. However, at high-dose long-term levels, the effects of exogenous glucocorticoids can cause significant immunosuppression, placing patients at a greater risk of infection. 9 Thus, management of patients with adrenal insufficiency should include antibiotic prophylaxis before

to approximately 75–95% of cases), malnutrition, intravenous drug use, diabetes mellitus, acquired immune deficiency syndrome, immunosuppression, and systemic lupus erythematosus. 1 Signs and symptoms of LA include malaise, dysphagia, drooling, bilateral cervical swelling, neck tenderness, dysphonia, elevation, posterior displacement and swelling of the tongue, pain in the floor of the mouth, sore throat, restricted neck movement, and stridor. 2 These signs and symptoms suggest impending airway obstruction. 1 During the past century, in at-risk populations, the

anatomic asplenia, immunodeficiency, immunosuppression from cancer chemotherapy, infection with HIV, and receipt of a hematopoietic stem cell transplant. 5 For high-risk patients who are also previously unvaccinated, the administration of at least 1 pediatric dose of an HiB conjugate vaccine should be considered. There are a variety of adjuvant therapies available that can be utilized on a case-by-case basis. Administration of supplemental humidified oxygen along with IV hydration can help to limit the risk of sudden airway obstruction. 9 Glucocorticoids are

LR, Rose EB, Horwitz SM, et al . Multisystem inflammatory syndrome in U.S. children and adolescents . N Engl J Med . 2020 ; 383 : 334 – 346 . 27.  Arvas A. Vaccination in patients with immunosuppression . Turk Pediatri Ars