<prompt> A patient with bronchiectasis develops nephrotic syndrome. The most probable diagnosis is?SLECystic fibrosisAmyloidosisHIV  <response>: ANSWER: C AmyloidosisREF: Interstitial Lung Disease by Marvin L Schwarz, Talmadge E. King Jr., SchwTarz, Talmadge E. King, Jr. M.D Page 1095, Harrisons 18th ed, Robbins 8th edIn addition to respiratory tract involvement, nephrotic syndrome is seen in 33 of patients with primary amyloidosis, myocardiopathy in 25, neuropathy in 17, and gastrointestinal involvement in 8 of cases. Furthermore, amyloidosis is a complication of long-standing bronchiectasis, which can also result in nephrotic syndrome.Bronchiectasis and nephritic syndrome are seen in following conditions:SLECystic fibrosis RareAmyloidosis amyloidosis is a complication of long-standing bronchiectasis, wThich can also result in nephrotic syndromeImmunodeficiencyOption A: In connective tissue disorders like SLE, the systemic manifestations generally precede the pulmonary manifestations. Also Pleuritis with or without effusion is the most common pulmonary manifestationOption B: Cystic fibrosis causes about half of all cases of bronchiectasis. Renal disease is not usually considered a major problem in CF. This is surprising since the cystic fibrosis transmembrane conductance regulator CFTR protein is expressed in all nephron segments of the kidney Morales etal, 2000Option D: Most common pulmonary manifestation of HIV is pneumonia not bronchiectasis, however chronic HIV-associated lung disease including bronchiectasis. But nephropathy usually comes first as it is a direct manifestation of HIV virus itself 