To the Editor.—
We report a case of celiac disease thought to be precipitated by the high gluten content of the meals ready to eat (MRE) that were supplied to the patient while serving in the Persian Gulf during Operation Desert Shield.
Report of a Case.—
A 23-year-old white male Army medic who was without any medical problems before deployment to Saudi Arabia in September 1990 noted the acute onset of anorexia and progressive fatigue in mid-November 1990. In December, he began having five to eight watery stools a day, with a subsequent 25-pound weight loss. The diarrhea persisted through December, and, with the development of marked edema from his lower extremities to his waist, he sought medical attention. Stool specimens were negative for enteric pathogens, ova and parasites, and leukocytes. Abdominal computed tomographic scan showed a dilated fluid-filled bowel and mesenteric adenopathy. On patient's returning to the United States,