PT  - JOURNAL ARTICLE
AU  - Szatmári
AU  - Teske
AU  - Nikkels
AU  - Griese
AU  - De Jong
AU  - Grinwis
AU  - Theegarten
AU  - Veraa
AU  - Steenbeek
AU  - Drent
AU  - Bonella
TI  - Pulmonary alveolar proteinosis in a cat
AID  - 10.1183/13993003.congress-2015.PA821
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA821
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA821.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA821.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Pulmonary alveolar proteinosis (PAP), accumulation of surfactant in the alveoli, was diagnosed in an 8-month-old cat with chronic tachypnea, failure to thrive and finally respiratory distress. After performing thoracic radiographs, routine blood tests and fecal parasitological examination on an awake animal, a bronchoscopy was performed under general anesthesia. The diagnosis of PAP was based on the milky appearance of the bronchoalveolar lavage fluid (BAL). Because of the worsening of the respiratory distress, development of anorexia and because of the poor prognosis the owners decided to let the kitten euthanized shortly after the bronchoscopy. Permission was granted for post mortem examinations.After performing a CT-scan of the thorax necropsy was performed. On the lung samples histopathology and electron microscopy were performed. On the stored serum, BAL and DNA various tests were carried out. 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 PAP 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. Energy dispersive X-ray analysis revealed intra-alveolar silicon, which is thought to be a coincidental finding, most likely originating from cat litter filling.Conclusion: This is the first report of PAP in the feline species. Radiographic, bronchoscopic, CT-scan, clinicopathologic, gross anatomic, histopathologic and electron microscopic findings are very similar to those in humans.