Auricular Cartilage Calcification and Adrenal Insufficiency  

Oleh:

Uthoff, Heiko ; Wiesli, Peter

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 02 (Jan. 2011), page 157.
Topik: Auricular Cartilage
Fulltext: Iron-Chelating Therapy.pdf (51.12KB)

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Perpustakaan FK Nomor Panggil: N08.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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A healthy 60-year-old man presented to the emergency department with profound hypotension 1 day after sustaining a minor hand laceration with minimal blood loss. Physical examination revealed stiffness in both ears, and calcification of the ears was subsequently revealed on computed tomography (Panel A, arrows) and radiography (Panel B, arrows). The patient's hemodynamic status improved promptly after administration of antibiotics and glucocorticoids, and he recovered with support from the intensive care unit. Throughout his 20-day hospital stay, bacterial cultures remained negative. Subsequent detailed investigations showed adrenal insufficiency resulting from autoimmune hypophysitis, with isolated failure to secrete corticotropin. Long-term glucocorticoid-replacement therapy has resulted in marked abatement of the patient's long-standing fatigue. Although rare, calcification and even true ossification of the auricular cartilages have been described in association with mechanical tissue injury, exposure to cold, inflammatory conditions, and endocrinopathies. Recognition of the association between auricular calcification and adrenal insufficiency can be an important step toward the identification of a life-threatening cortisol deficiency.

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