Calcification of auricular cartilages in patients with hypopituitarism

Primary adrenal insufficiency is the most frequent systemic disorder associated with calcification of auricular cartilage. The pathogenesis of this sign has been attributed to ACTH excess or to prolonged desoxycorticosterone acetate therapy. We describe here three patients with long-standing untreated hypopituitarism and calcified auricular cartilages. Replacement hormonal therapy resulted in improvement in their general condition, but did not change the auricular calcification. Analysis of these cases as well as review of the literature suggest that calcification of auricular cartilage in both Addison's disease and hypopituitarism results from long-standing cortisol deficiency. However, the exact pathophysiological mechanism of this phenomenon as well as its occurrence exclusively in males remain unclear.