title: [Refractory pulmonary alveolar proteinosis treated with inhaled granulocyte macrophage colony stimulating factor: a case report and review of the literatures].
abstract: OBJECTIVE
  To observe the efficacy of granulocyte macrophage colony stimulating factor inhalation therapy for pulmonary alveolar proteinosis (PAP) patients and to improve the understanding of the therapy.
  
  
  METHODS
  The clinical data of a patient with autoimmune PAP treated with inhaled granulocyte macrophage colony stimulating factor were described and the literatures were reviewed.
  
  
  RESULTS
  This 70-year-old female patient was diagnosed with autoimmune PAP and had been treated with whole lung lavage for 10 times, but only achieved short-term symptomatic relief after each operation. Inhalation of granulocyte macrophage colony stimulating factor was then used after the recurrence of PAP, and a significant improvement in oxygenation and clinical symptoms were abserved. The patient remained stable 4 month after the therapy.
  
  
  CONCLUSIONS
  Treatment with inhalation of granulocyte macrophage colony stimulating factor is safe, effective and economic for patients with PAP, and would be the first choice for the recurrence of autoimmune PAP after whole lung lavage.
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Wenliang
authors.initials: W
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Yunxiang
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Zhuquan
authors.initials: Z
authors.lastname: Su
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Changhao
authors.initials: C
authors.lastname: Zhong
authors.affiliation: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Email: lishiyue@188.com.
authors.forename: Shiyue
authors.initials: S
authors.lastname: Li
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001327:Autoimmune Diseases; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D006801:Humans; D011649:Pulmonary Alveolar Proteinosis; D012008:Recurrence; D012138:Respiratory Therapy
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor