Hyperechoic kidneys in a patient with bronchiectasis.

Introduction: Hyperechoic renal cortex in a normal-sized kidney has a range of causes, some of which irreparably damage the kidney and should initiate further investigations.

Case report: We present a 72-year-old woman with longstanding bronchiectasis, noticed to have worsening renal function. Renal tract ultrasonography showed hyperechoic normal-sized kidneys. Renal biopsy confirmed amyloidosis.

Discussion: Imaging findings in renal amyloidosis tend to be non-specific and are not always present. However, ultrasonography findings of hyperechoic cortex in normal-sized kidneys should not be ignored.

Conclusion: Renal impairment from blood chemistry in addition to hyperechoic kidneys may be the key to diagnosing secondary amyloidosis in a patient with bronchiectasis, a rare association but important to recognise.