Infants born prematurely can be intubated for a longer amount of time due to the fact that they have more flexible cartilage and a larynx located high in the airway. 90% of acquired cases in children are due to intubation, due to the ring of cartilage in the upper airway. Less commonly, infections, such as bacterial tracheitis, tuberculosis, histoplasmosis, diphtheria, and laryngeal papillomatosis can cause it. Systemic diseases, such as amyloidosis, granulomatosis with polyangiitis, sarcoidosis, inflammatory bowel disease, scleroderma, relapsing polychondritis, and polyarthritis, can also cause it. Other causes may include aspiration of foreign bodies, burns, and exposure to occupational hazards. Very rarely, the condition may also have no known cause, in which case it is known as idiopathic subglottic stenosis. Mechanism
High cuff pressure or long-term intubation can cause damage to the tracheal mucosa, causing inflammation, ulceration, and breakdown of cartilage. When the injury heals, scarring occurs, narrowing the airway. Treatment-related risk factors include repeated intubation, the presence of a nasogastric tube, and size of an endotracheal tube. Person-related risk factors include systemic diseases, the likelihood of infection, and inadequate perfusion. Acid reflux may cause narrowing due to scarring resulting from stomach acid damaging the tracheal mucosa. 10-23% of causes result due to narrowing arising from granulomatosis with polyangiitis. In these cases, it is believed that this is more common in people under the age of 20. Around 66% of sarcoidosis cases involve the airway. Diagnosis
CT scans and MRI (magnetic resonance imaging) can help in diagnosis.
Larger than petechiae, ecchymoses are purple, blue, or yellow-green areas of skin that vary in size and shape. They can occur anywhere on the body.A person with this disease may also complain of malaise, fatigue, and general weakness (with or without accompanying blood loss). Acquired thrombocytopenia may be associated with the use of certain drugs. Inspection typically reveals evidence of bleeding (petechiae or ecchymoses), along with slow, continuous bleeding from any injuries or wounds. Adults may have large, blood-filled bullae in the mouth. If the persons platelet count is between 30,000 and 50,000/mm3, bruising with minor trauma may be expected; if it is between 15,000 and 30,000/mm3, spontaneous bruising will be seen (mostly on the arms and legs). Causes
Thrombocytopenia can be inherited or acquired.