A patient who has been diagnosed with bronchiectasis 5 years ago presents with edema on legs and proteinuria. The most likely finding in his kidney will be:
Answer is B (Amyloid Nephropathy): Secondary / Reactive Amyloidosis is an established typical complication of chronic conditions like bronchiectasis. Secondary amyloidosis is typically distributed in solid abdominal viscera like the kidney, liver, spleen and adrenals. Kidneys are the most frequently affected organs. Renal Amyloidosis is an established cause of secondary glomerular disease from chronic conditions like bronchiectasis and presence of edema on legs and proteinuria in a patient with chronic bronchiectasis should auggests the possibility of secondary/reactive renal amyloidosis. 'Renal Amyloidosis is usually manifested as proteinuria, often in the nephrotic range and associated with significant hypoalbuminemia, and edema or anasarca' - Harrison 18'h/947 Bronchiectasis is the most common respiratory disease underlying AA Amylodosis in the UK.
Minimal Change Disease
Amyloid Nephropathy
Rapidly Progressive Glomerulonephritis (RPGN)
Crescenteric Glomerulonephritis