A Woman With Dyspnea and Bronchiectasis

A 41-year-old woman with an 8 –pack-year history of tobacco use had 4 years of progressive cough and dyspnea. She had no history of neonatal respiratory distress or nasal congestion and no family history of COPD or cystic fibrosis; pulmonary function testing showed a severe obstruction and chest CT showed lower lobe predominan t emphysema and bronchiectasis. What is the diagnosis and what would you do next?
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research