Prevalence of Elevated IgG4 in Patients with Nasopharynx and Laryngopharynx Diseases: A Systematic Review and Meta-Analysis

Elevated Immunoglobulin G4 (IgG4) levels have been implicated in various autoimmune and inflammatory diseases, including those affecting the nasopharynx and laryngopharynx. The current systematic review and meta-analysis aimed to determine the prevalence of elevated IgG4 and associated risk factors in patients with nasopharynx and laryngopharynx diseases. This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of PubMed, Embase, Web of Science, and Scopus databases was performed from inception until July 2024. Keywords and Medical Subject Headings (MeSH) terms A random-effects model was used to pool prevalence estimates, and heterogeneity was assessed using the I² statistic. Publication bias was evaluated using funnel plots and Egger’s test.From 922 records, 11 studies met the inclusion criteria. The pooled prevalence of elevated IgG4 levels was 33.9% (95% CI: 19.1%-52.6%), with significant heterogeneity (I² = 85.433%, P < 0.001). The highest frequency was reported in a Chinese study (96.9%), and the lowest in a Turkish study (0.2%). Sensitivity analyses confirmed the robustness of the results, and no significant bias was detected. The findings illustrated a high level of elevated IgG4 levels among patients with nasopharynx and laryngopharynx diseases, with considerable variability across different populations and settings, highlighting the need for further research to understand the clinical implications and diagnostic utility of IgG4 in ENT diseases.