Other genetic conditions that lead to PAP include a recently identified mutation in the beta chain of the GMCSF receptor [9] , surfactant protein B or C deficiency [10, 11] , Niemann-Pick Type C2 disease [12] and lysinuric protein intolerance [13] . Secondary PAP develops in association with conditions involving functional impairment or reduced numbers of alveolar macrophages like inhalation of inorganic dusts, myeloic leukemia, myelodysplastic syndrome, immunosuppression related to organ transplantation, and some infections including Pneumocystis [1] .