Abstract
The subsequent breakdown of the alveolar lining, overproduction of substances normally secreted into the alveoli, impairment of alveolar clearance and the transudation of plasma constituents into the alveoli may contribute to the pathogenesis of PAP. Treatment of PAP with lung lavage and treatment of infections should show improvement .GM-CSF therapy has shown beneficial in decreasing the concentration of total protein ,SP-A in BALF, and increase interleukin-17 and cancer antigen-125 in improved lung of pulmonary alveolar proteinosis .This case report signifies the importance of using GM-CSF with no improvement in treatment of PCP alone.