[Ears "made of stone" - unusual secondary phenomenon of undersubstituted adrenal insufficiency].
METHODS
A 69-year-old man was admitted with cough, fever and dyspnea. For years, an adrenal insufficiency has been substituted with low-dose hydrocortisone. The hypotensive and tachycardic patient exhibited remarkable stony hard ears.


METHODS
Elevated inflammatory markers and the clinical picture point to a pulmonary focus of infection. Radiographs of the ears show trabecular structures as a sign of true ossification.


METHODS
Addisonian crisis due to pulmonary infection was treated successfully with steroids, antibiotics and intravenous fluids. The auricular ossification was interpreted as a secondary phenomenon of undersubstituted adrenal insufficiency.


CONCLUSIONS
Adrenal insufficiency should be considered when auricular ossification is encountered. The pathogenesis of this phenomenon is complex and not well understood.
Richter
Jens Christian
JC
Klinik für Innere Medizin, Regionalspital Emmental, Burgdorf, Schweiz. j.c.richter_md@hotmail.com
Chappuis
B
B
D000224:Addison Disease / Q000150:complications* / Q000188:drug therapy; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002114:Calcinosis / Q000175:diagnosis / Q000209:etiology*; D002356:Cartilage / Q000000981:diagnostic imaging / Q000473:pathology; D004427:Ear Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage* / Q000009:adverse effects; D007877:Legionnaires' Disease / Q000150:complications / Q000175:diagnosis; D008297:Male; D009999:Ossification, Heterotopic / Q000175:diagnosis / Q000209:etiology*; D011859:Radiography
D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone