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Updated: Jun 20, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
[Ears "made of stone" - unusual secondary phenomenon of undersubstituted adrenal insufficiency]
Jens Christian Richter1, B Chappuis
1Klinik für Innere Medizin, Regionalspital Emmental, Burgdorf, Schweiz. j.c.richter_md@hotmail.com
History And Clinical Findings:
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.
Investigations:
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.
Diagnosis, Treatment And Course:
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.
Conclusion:
Adrenal insufficiency should be considered when auricular ossification is encountered. The pathogenesis of this phenomenon is complex and not well understood.
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