Camilla Pasternack1, Katri Kaukinen1,2,3, Kalle Kurppa4, Markku Mäki4, Pekka Collin5, Timo Reunala1,6, Heini Huhtala7, Teea Salmi8,9. 1. School of Medicine, University of Tampere, Tampere, Finland. 2. Department of Internal Medicine, Tampere University Hospital, Tampere, Finland. 3. Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. 4. Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. 5. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. 6. Department of Dermatology, Tampere University Hospital, PO.Box 2000, 33521, Tampere, Finland. 7. Tampere School of Health Sciences, University of Tampere, Tampere, Finland. 8. School of Medicine, University of Tampere, Tampere, Finland. teea.salmi@uta.fi. 9. Department of Dermatology, Tampere University Hospital, PO.Box 2000, 33521, Tampere, Finland. teea.salmi@uta.fi.
Abstract
BACKGROUND: Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking. OBJECTIVE: The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life. METHODS: Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls. RESULTS: The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life. CONCLUSION: We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.
BACKGROUND:Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac diseasepatients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking. OBJECTIVE: The aim was to evaluate whether long-term GFD-treated DHpatients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life. METHODS:Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DHpatients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls. RESULTS: The median age of the DHpatients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DHpatients were compared with healthy controls, but treated DHpatients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DHpatients had more severe gastrointestinal symptoms and reduced vitality compared with male DHpatients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life. CONCLUSION: We conclude that long-term GFD-treated DHpatients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.