The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis

Abstract Background Birt-Hogg-Dubé (BHD) syndrome is associated with an increased risk of pneumothorax. This study aimed to determine the prevalence of spontaneous pneumothorax among individuals diagnosed with BHD syndrome. Method A comprehensive literature search was conducted across PubMed, EMBASE...

Full description

Saved in:
Bibliographic Details
Main Authors: Yanan Zhang, Yuling Wang, Jinxia Wang, Ping Li, Ruonan Lv, Juan Chen
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-025-03726-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849729029565841408
author Yanan Zhang
Yuling Wang
Jinxia Wang
Ping Li
Ruonan Lv
Juan Chen
author_facet Yanan Zhang
Yuling Wang
Jinxia Wang
Ping Li
Ruonan Lv
Juan Chen
author_sort Yanan Zhang
collection DOAJ
description Abstract Background Birt-Hogg-Dubé (BHD) syndrome is associated with an increased risk of pneumothorax. This study aimed to determine the prevalence of spontaneous pneumothorax among individuals diagnosed with BHD syndrome. Method A comprehensive literature search was conducted across PubMed, EMBASE, Cochrane Controlled Register of Trials (CENTRAL), and Web of Science databases up to March 10, 2024. Studies reporting on the prevalence of spontaneous pneumothorax in BHD syndrome patients were included. Eligibility assessment, data extraction, and quality assessment were performed independently by two reviewers. Random-effects or fixed-effect models were conducted to calculate pooled incidence rates, and subgroup analyses were performed to explore sources of heterogeneity. The publication bias was assessed by funnel plot and Egger's test. Results Eighteen studies, conducted between 2009 and 2023, were included in the systematic review. The meta-analysis revealed a pooled incidence rate of spontaneous pneumothorax in BHD syndrome patients at 0.61 (95% CI 0.46; 0.76). Subgroup analyses based on region, study design, and diagnostic methods further elucidated variations in incidence rates among different patient groups. Specifically, the Asian subgroup demonstrated a higher pooled incidence rate of 0.71 (95% CI 0.60; 0.81), while the Caucasian subgroup showed a lower pooled incidence rate of 0.43 (95% CI 0.26; 0.60). The subgroup analysis by study design revealed a pooled incidence rate of 0.60 (95% CI 0.45; 0.76) for retrospective studies and 0.70 (95% CI 0.42; 0.98) for the sole prospective study. Additionally, the subgroup analysis by diagnostic methods showed pooled incidence rates of 0.64 (95% CI 0.48; 0.81) for studies using FLCN mutation testing and 0.51 (95% CI 0.33; 0.70) for those using clinical criteria and imaging findings. Potential publication bias was identified by Egger's test (P < 0.05). Conclusion The study indicated a pooled prevalence rate of 61% for pneumothorax in BHD syndrome patients, with subgroup analyses revealing higher rates among Asian individuals and in prospective studies. Further researches, particularly large-sample prospective studies, are needed to address publication bias and improve the reliability of prevalence estimates. PROSPERO: CRD42024567520.
format Article
id doaj-art-0be2f91ef4044dd8b6911ed02b43c4cc
institution DOAJ
issn 1750-1172
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series Orphanet Journal of Rare Diseases
spelling doaj-art-0be2f91ef4044dd8b6911ed02b43c4cc2025-08-20T03:09:20ZengBMCOrphanet Journal of Rare Diseases1750-11722025-05-0120111410.1186/s13023-025-03726-zThe prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysisYanan Zhang0Yuling Wang1Jinxia Wang2Ping Li3Ruonan Lv4Juan Chen5Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical UniversityNingxia Medical UniversityNingxia Medical UniversityDepartment of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical UniversityNingxia Medical UniversityDepartment of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical UniversityAbstract Background Birt-Hogg-Dubé (BHD) syndrome is associated with an increased risk of pneumothorax. This study aimed to determine the prevalence of spontaneous pneumothorax among individuals diagnosed with BHD syndrome. Method A comprehensive literature search was conducted across PubMed, EMBASE, Cochrane Controlled Register of Trials (CENTRAL), and Web of Science databases up to March 10, 2024. Studies reporting on the prevalence of spontaneous pneumothorax in BHD syndrome patients were included. Eligibility assessment, data extraction, and quality assessment were performed independently by two reviewers. Random-effects or fixed-effect models were conducted to calculate pooled incidence rates, and subgroup analyses were performed to explore sources of heterogeneity. The publication bias was assessed by funnel plot and Egger's test. Results Eighteen studies, conducted between 2009 and 2023, were included in the systematic review. The meta-analysis revealed a pooled incidence rate of spontaneous pneumothorax in BHD syndrome patients at 0.61 (95% CI 0.46; 0.76). Subgroup analyses based on region, study design, and diagnostic methods further elucidated variations in incidence rates among different patient groups. Specifically, the Asian subgroup demonstrated a higher pooled incidence rate of 0.71 (95% CI 0.60; 0.81), while the Caucasian subgroup showed a lower pooled incidence rate of 0.43 (95% CI 0.26; 0.60). The subgroup analysis by study design revealed a pooled incidence rate of 0.60 (95% CI 0.45; 0.76) for retrospective studies and 0.70 (95% CI 0.42; 0.98) for the sole prospective study. Additionally, the subgroup analysis by diagnostic methods showed pooled incidence rates of 0.64 (95% CI 0.48; 0.81) for studies using FLCN mutation testing and 0.51 (95% CI 0.33; 0.70) for those using clinical criteria and imaging findings. Potential publication bias was identified by Egger's test (P < 0.05). Conclusion The study indicated a pooled prevalence rate of 61% for pneumothorax in BHD syndrome patients, with subgroup analyses revealing higher rates among Asian individuals and in prospective studies. Further researches, particularly large-sample prospective studies, are needed to address publication bias and improve the reliability of prevalence estimates. PROSPERO: CRD42024567520.https://doi.org/10.1186/s13023-025-03726-zBirt-Hogg-Dubé syndromeSpontaneous pneumothoraxFolliculinPrevalenceMeta-analysis
spellingShingle Yanan Zhang
Yuling Wang
Jinxia Wang
Ping Li
Ruonan Lv
Juan Chen
The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
Orphanet Journal of Rare Diseases
Birt-Hogg-Dubé syndrome
Spontaneous pneumothorax
Folliculin
Prevalence
Meta-analysis
title The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
title_full The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
title_fullStr The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
title_full_unstemmed The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
title_short The prevalence of spontaneous pneumothorax in patients with BHD syndrome: a systematic review and meta-analysis
title_sort prevalence of spontaneous pneumothorax in patients with bhd syndrome a systematic review and meta analysis
topic Birt-Hogg-Dubé syndrome
Spontaneous pneumothorax
Folliculin
Prevalence
Meta-analysis
url https://doi.org/10.1186/s13023-025-03726-z
work_keys_str_mv AT yananzhang theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT yulingwang theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT jinxiawang theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT pingli theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT ruonanlv theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT juanchen theprevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT yananzhang prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT yulingwang prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT jinxiawang prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT pingli prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT ruonanlv prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis
AT juanchen prevalenceofspontaneouspneumothoraxinpatientswithbhdsyndromeasystematicreviewandmetaanalysis