Deutsche medizinische Wochenschrift (1946) · 2009
[Ears "made of stone" - unusual secondary phenomenon of undersubstituted adrenal insufficiency].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Richter Jens Christian, Chappuis B
Аннотация
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.
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.