Gunn, Shelly R, Gunn, G Gibson, Mueller, Francis W · The American journal of case reports · 2016 · DOI
This case report describes one 25-year-old man who had both severe inflammatory bowel disease and chronic fatigue syndrome that improved dramatically after identifying and removing mold exposure from his home, receiving a hormone replacement therapy (VIP), and doing stress-reduction exercises. The patient's genetic makeup made him more susceptible to problems when exposed to toxic mold, and treating the underlying immune disturbance resolved his symptoms without medication.
This case suggests that in genetically susceptible individuals, ME/CFS symptoms may overlap with or arise from biotoxin-related immune dysregulation, opening an alternative investigative pathway for a subset of patients. The potential reversibility of severe symptoms highlights the importance of considering environmental and immune biomarker assessment in refractory cases, even when standard autoimmune workups are negative.
This single case report cannot establish that biotoxin exposure causes ME/CFS in the broader patient population, nor does it prove that VIP replacement or mold remediation will benefit other patients. The temporal relationship between interventions and symptom resolution does not prove causation, and the simultaneous implementation of multiple treatments makes it impossible to identify which intervention(s) were actually responsible for improvement.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Gunn, Shelly R, Gunn, G Gibson, & Mueller, Francis W (2016). Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures.. The American journal of case reports. https://doi.org/10.12659/ajcr.896949
BibTeX
@article{mecfsatlas-gunn-2016-reversal-refractory,
author = {Gunn, Shelly R and Gunn, G Gibson and Mueller, Francis W},
title = {Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures.},
journal = {The American journal of case reports},
year = {2016},
doi = {10.12659/ajcr.896949},
note = {PubMed: 27165859},
url = {https://www.mecfsatlas.com/evidence/gunn-2016-reversal-refractory},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/gunn-2016-reversal-refractory
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