Aims: To evaluate health-related quality of life (HRQoL) in celiac disease (CD) patients at the time of diagnosis and during a gluten-free diet (GFD). Patients and Methods: We enrolled 43 adult CD patients (18 with a typical and 15 with an atypical clinical presentation, and 10 with dermatitis herpetiformis, DH) and 86 age- and sex-matched healthy controls. We administered the Short Form 36 Health Survey (SF-36) questionnaire at diagnosis and after 1, 12 and 24 months of a GFD. Results: At the time of diagnosis CD patients showed significantly lower SF-36 scores than controls; this figure was observed in women but not in men. At baseline, both typical and atypical CD patients had lower SF-36 scores than controls, while DH patients showed a SF-36 profile comparable to that of controls. During a GFD the SF-36 scores improved continuously in CD patients and in the female subgroup, becoming similar to those of matched controls at 1-year follow-up. After gluten withdrawal typical and atypical CD patients improved their SF-36 scores and reached values comparable to those of controls. Conclusions: At diagnosis, CD patients perceived a poor HRQoL; this figure appears to be mostly associated with female gender. In all subgroups of CD patients with a low HRQoL at diagnosis, the GFD allowed progressive restoration of HRQoL perception.

1.
Trier JS: Celiac sprue. N Engl J Med 1991;325:1709–1719.
[PubMed]
2.
Rostom A, Murray JA, Kagnoff MF: American Gastroenterological Association Institute technical review on the diagnosis and management of celiac disease. Gastroenterology 2006;131:1981–2002.
[PubMed]
3.
Lee A, Newman JM: Celiac diet: its impact on quality of life. J Am Diet Assoc 2003;103:1533–1535.
[PubMed]
4.
Logan RF: Descriptive epidemiology of celiac disease; in Branski D, Rozen P, Kagnoff MF (eds): Gluten-Sensitive Enteropathy. Basel, Karger, 1992, pp 1–14.
5.
Catassi C, Ratsch IM, Fabiani E, Rossini M, Bordicchia F, Candela F, et al: Celiac disease in the year 2000: exploring the iceberg. Lancet 1994;343:200–203.
[PubMed]
6.
Collin P, Kaukinen K, Maki M: Clinical features of celiac disease today. Dig Dis 1999;17:100–106.
[PubMed]
7.
Pietzak MM, Catassi C, Drago S, et al: Celiac disease: going against the grains. Nutr Clin Prac 2001;16:335–344.
8.
Van der Meer R: Granular deposits of immunoglobulins in the skin of the patients with dermatitis herpetiformis. Br J Dermatol 1969;81:493–503.
[PubMed]
9.
Fry L, Seah PP, Riches DJ, Hoffbrand AV: Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal. Lancet 1973;i:288–291.
10.
Marsh MN: Mucosal pathology in gluten sensitivity; in Marsh MN (ed): Coeliac Disease. Oxford, Blackwell Scientific, 1992 pp 136–191.
11.
Oberhuber G, Granditsch G, Vogelsang H: The histopathology of celiac disease: time for a standardized report scheme for pathologist. Eur J Gastroenterol Hepatol 1999;11:1185–1194.
[PubMed]
12.
Ware JE: SF-36 literature, construction of the SF-36, version 2.0, psychometric considerations, translations, discussion. The SF Community – SF-36 Health Survey Update. www.sf-36.org.
13.
Apolone G, Cifani S, Mosconi P, et al: Questionario sullo stato di salute SF36. Traduzione e validazione della versione italiana: risultati del progetto IQOLA. Medic 2, 1997.
14.
Apolone G, Mosconi P: The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol 1998;11:1025–1036.
15.
Ware JE Jr, Keller SD, Gandek B, Brazier JE, Sullivan M: Evaluating translations of health status questionnaires. Methods from the IQOLA project. International Quality of Life Assessment. Int J Technol Assess Health Care 1995;11:525–551.
[PubMed]
16.
Drossman DA, Patrick DL, Mitchell CM, Zagami EW, Appalbaum MI: Health-related quality of life in inflammatory bowel disease. Functional status and patients worries and concerns. Dig Dis Sci 1989;34:1379–1386.
[PubMed]
17.
Ware JE Jr, Gandek B, for the IQOLA Project Group: Methods for testing data quality, scaling assumptions and reliability: the IQOLA Project approach. J Clin Epidemiol 1998;51:945–952.
[PubMed]
18.
Hauser W, Gold J, Stallmach A, Caspary WF, Stein J: Development and validation of the Celiac Disease Questionnaire (CDQ), a disease-specific health-related quality of life measure for adult patients with celiac disease. J Clin Gastroenterol 2007;41:157–166.
[PubMed]
19.
Leffler D, Dennis M, Edwards GJ, Jamma S, Magge S, Cook E, Schuppan D, Kelly C: A simple validated gluten-free diet adherence survey for adults with celiac disease. Clin Gastroenterol Hepatol 2009;7:530–536.
[PubMed]
20.
Casellas F, Rodrigo L, López Vivancos J, et al: Factors that impact health-related quality of life in adults with celiac disease: a multicenter study. World J Gastroenterol 2008;14:46–52.
[PubMed]
21.
Nachman F, Mauriño E, Vázquez H, et al: Quality of life in celiac disease patients. Prospective analysis on the importance of clinical severity at diagnosis and the impact of treatment. Dig Liver Dis 2009;41:15–25.
[PubMed]
22.
Cranney A, Zarkadas M, Graham D, Switzer C: The Canadian celiac health survey – the Ottawa chapter pilot. BMC Gastroenterol 2003;11:3–8.
23.
Mustalahti K, Lohiniemi S, Collin P, Vuooltenaho N, Laippala P, Maki M: Gluten-free diet and quality of life in patients with screen-detected celiac disease. Eff Clin Pract 2002;5:105–113.
[PubMed]
24.
Johnston SD, Rodgers C, Watson RGP: Quality of life in screen-detected and typical celiac disease and the effect of excluding dietary gluten. Eur J Gastroenterol Hepatol 2004;16:1281–1286.
[PubMed]
25.
Hallert C, Granno C, Grant C, Hulten S et al: Quality of life of adult coeliac patients treated for 10 years. Scand J Gastroenterol 1998;33:993–998.
[PubMed]
26.
Midhagen G, Hallert C: High rate of gastrointestinal symptoms in celiac patients living on a gluten-free diet: controlled study. Am J Gastroenterol 2003;98:2023–2026.
[PubMed]
27.
Ciacci C, D’Agate C, De Rosa A, et al: Self-rated quality of life in celiac disease. Dig Dis Sci 2003;48:2216–2220.
[PubMed]
28.
Usai P, Minerba L, Marini B, et al: Case control study on health-related quality of life in adult coeliac disease. Dig Liver Dis 2002;34:547–552.
[PubMed]
29.
Fera T, Cascio B, Angelini G, Martini S, Guidetti CS: Affective disorders and quality of life in adult coeliac disease patients on a gluten-free diet. Eur J Gastroenterol Hepatol 2003;15:1287–1292.
[PubMed]
30.
Green PHR, Stavropoulos SN, Panagi SG, et al: Characteristics of adult celiac disease in the USA: result of a national survey. Am J Gastroenterol 2001;96:126–131.
[PubMed]
31.
O’Leary C, Wieneke P, Buckley S, et al: Celiac disease and irritable bowel-type symptoms. Am J Gastroenterol 2002;97:1463–1467.
[PubMed]
You do not currently have access to this content.