title: Pulmonary alveolar proteinosis in a cat.
abstract: BACKGROUND
  Pulmonary alveolar proteinosis is an extremely rare lung disease in animals and humans. It is characterized by the deposition of a large amount of phospholipoproteinaceous material in the alveoli. There are several possible etiologies, both congenital and acquired. Alveolar macrophages play an important role in the clearance of surfactant. This is the first report of pulmonary alveolar proteinosis in the feline species.
  
  
  METHODS
  Pulmonary alveolar proteinosis was diagnosed in an 8-month-old cat with chronic tachypnea, failure to thrive and finally respiratory distress. The diagnosis was based on the milky appearance of the bronchoalveolar lavage fluid taken under general anesthesia after bronchoscopy. Because of the worsening respiratory distress and development of anorexia the kitten was euthanized. Histopathology of the lungs showed alveoli and bronchi filled with eosinophilic material. Electron microscopy revealed lamellated intra-alveolar bodies. As the granulocyte-macrophage colony-stimulating factor was elevated in the serum and no autoantibodies against granulocyte-macrophage colony-stimulating factor were detected, a primary hereditary pulmonary alveolar proteinosis was suspected. The underlying cause was thought to be a dysfunction of the receptor of the granulocyte-macrophage colony-stimulating factor, however, a mutation in the genes encoding the alpha and beta chains of this receptor has not been found.
  
  
  CONCLUSIONS
  This is the first description of pulmonary alveolar proteinosis in a cat. This kitten is thought to have a primary hereditary pulmonary alveolar proteinosis with a possible defect in the signalling pathway of the receptor of the granulocyte-macrophage colony-stimulating factor. The imaging and pathologic findings are similar to those of humans.
authors.affiliation: Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. v.szatmari@uu.nl.
authors.forename: Viktor
authors.initials: V
authors.lastname: Szatmári
authors.affiliation: Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. e.teske@uu.nl.
authors.forename: Erik
authors.initials: E
authors.lastname: Teske
authors.affiliation: Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. P.G.J.Nikkels@umcutrecht.nl.
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Nikkels
authors.affiliation: Dr von Haunersches Kinderspital, University of Munich, Munich, Germany. Matthias.Griese@med.uni-muenchen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Griese
authors.affiliation: Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands. pimdejong@gmail.com.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. g.c.m.grinwis@uu.nl.
authors.forename: Guy
authors.initials: G
authors.lastname: Grinwis
authors.affiliation: Institute of Pathology and Neuropathology, University Hospital, University of Duisburg-Essen, Essen, Germany. dirk.theegarten@uk-essen.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Theegarten
authors.affiliation: Division of Diagnostic Imaging, Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. s.veraa@uu.nl.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Veraa
authors.affiliation: Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands. f.g.vansteenbeek@uu.nl.
authors.forename: Frank G
authors.initials: FG
authors.lastname: van Steenbeek
authors.affiliation: Interstitial Lung Diseases, Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, University Maastricht, Maastricht, The Netherlands. m.drent@hetnet.nl.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Drent
authors.affiliation: Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University Hospital, University of Duisburg-Essen, Essen, Germany. Francesco.Bonella@ruhrlandklinik.uk-essen.de.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonella
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000175:diagnosis* / Q000473:pathology; D002415:Cats; D005260:Female; D011649:Pulmonary Alveolar Proteinosis / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*