Spironolactone for ME/CFS in a Patient Homozygous for rs5522 (I180V): A Case Report

Spironolactone for ME/CFS in a Patient Homozygous for rs5522 (I180V): A Case Report | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 9 February 2026 V1 Latest version Share on Spironolactone for ME/CFS in a Patient Homozygous for rs5522 (I180V): A Case Report Author : Patricia Donnellan 0009-0003-6117-2527 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.177067531.10473859/v1 1376 views 169 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition with no consistently effective treatment. The mineralocorticoid receptor variant rs5522 (I180V) is associated with enhanced MR response to cortisol and altered stress responsiveness, but has not been linked to ME/CFS treatment response. Case: A 48-year-old woman with 28 years of treatment-resistant ME/CFS was found to be homozygous for rs5522. Following initiation of spironolactone, an MR antagonist, she experienced restorative sleep within 48 hours, resolution of post-exertional malaise within 3 days, and sustained functional improvement at one month. Conclusion: MR overactivity may drive ME/CFS in patients with rs5522. Genetic stratification could identify patients who benefit from MR antagonism. Supplementary Material File (title- spironolactone for me_cfs in a patient homozygous for rs5522 (i180v) a case report v2 (2).pdf) Download 57.77 KB Information & Authors Information Version history V1 Version 1 09 February 2026 Copyright This work is licensed under a Creative Commons Attribution 4.0 International License Keywords biomarker cortisol genetic stratification glucocorticoid receptor hpa axis i180v mineralocorticoid receptor myalgic encephalomyelitis/chronic fatigue syndrome rs5522 spironolactone Authors Affiliations Patricia Donnellan 0009-0003-6117-2527 [email protected] View all articles by this author Metrics & Citations Metrics Article Usage 1376 views 169 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Patricia Donnellan. Spironolactone for ME/CFS in a Patient Homozygous for rs5522 (I180V): A Case Report. Authorea . 09 February 2026. DOI: https://doi.org/10.22541/au.177067531.10473859/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. Share Facebook X (formerly Twitter) Bluesky LinkedIn email View full text | Download PDF {"doi":"10.22541/au.177067531.10473859/v1","type":"Article"} Now Reading: Share Figures Tables Close figure viewer Back to article Figure title goes here Change zoom level Go to figure location within the article Download figure Toggle share panel Toggle share panel Share Toggle information panel Toggle information panel Go to previous graphic Go to next graphic Go to previous table Go to next table All figures All tables View all material View all material xrefBack.goTo xrefBack.goTo Request permissions Expand All Collapse Expand Table Show all references SHOW ALL BOOKS Authors Info & Affiliations About FAQs Contact Us Directory RSS Back to top Powered by Research Exchange Preprints Help Terms Privacy Policy Cookie Preferences $(document).ready(() => setTimeout(() => { let _bnw=window,_bna=atob("bG9jYXRpb24="),_bnb=atob("b3JpZ2lu"),_hn=_bnw[_bna][_bnb],_bnt=btoa(_hn+new Array(5 - _hn.length % 4).join(" ")); $.get("/resource/lodash?t="+_bnt); },4000)); (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9fe37ed54ee258d3',t:'MTc3OTE5NzgzNw=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();