Auricular Ossification in Adrenal Insufficiency

Ming-Tsang Lee, Chih-Yuan Wang


A 50-year-old man presented with low serum ACTH level (10.4 pg/ml, normal 10 - 70), lower serum cortisol level (4.5 pg/dl, normal 5 - 25), hyponatremia (126 mmol/L, normal 135 - 153), hyperkalemia (5.4 mmol/L, normal 3.5 - 5.3) and hypereosinophilia (13% in differential count, normal < 2%). Physical examination revealed rigidity of ear cartilage without any signs of inflammation or scarring on the auricles. Skull X-ray demonstrated dense opacity over the auricular cartilage with normal sella turcica contour. Auricular ossification is a very rare phenomenon, and the hard, stony ear for such patients can only be moved as a single unit. Among endocrine disorders, adrenal insufficiency may be closely associated with ear ossification. We try to remind this forgotten phenomenon, ossification of auricles, for patients with adrenal insufficiency.

J Endocrinol Metab. 2011;1(1):45-46


Auricular ossification; Adrenal insufficiency; ACTH; Cortisol

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