Magerl M, Gandra RF, Menolli RA (2019) ANA-Hep2 Positive with Anti-Rods and Rings Pattern in a Child without Hepatitis C under Treatment: Case Report. J Rheum Dis Treat 5:073.


© 2019 Magerl M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2469-5726/1510073

ANA-Hep2 Positive with Anti-Rods and Rings Pattern in a Child without Hepatitis C under Treatment: Case Report

Mariana Magerl1, Rinaldo Ferreira Gandra1 and Rafael Andrade Menolli2*

1Western Parana University Hospital, Western Parana State University, 85806-470, Cascavel, PR, Brazil

2Laboratory of Applied Immunology, Center of Medical and Pharmaceutical Sciences, Western Parana State University, 85819-110, Cascavel, PR, Brazil



The immunofluorescence pattern of antinuclear antibodies (ANA) called rings and rods (RR) has only recently been described. This pattern has been associated with patients with Hepatitis C at treatment. There are few studies that demonstrate their appearance in healthy individuals or with other health conditions. This study reports positivity of this autoantibody in a patient never exposed to the HCV virus, in order to understand its clinical significance.

Case summary

A 10-year-old male patient was admitted to a university hospital with suspected bronchopneumonia. A carrier of chronic lung disease, he underwent several tests including ANA, that was reagent for the nucleus (fine speckled pattern) and cytoplasm (RR pattern). The serological results for hepatitis and HIV were negative. The patient was discharged after 22 days in hospital and is being followed-up by the outpatient clinic. There was a subsequent suspicion of immunodeficiency and cystic fibrosis, but there remains no established diagnosis. The presence of the pattern without the coexistence of Hepatitis C or the use of drugs such as RBV/IFN is scarce in the literature. No correlation between the RR pattern and the patient's clinical presentation is clear, but some studies have reported the appearance of this pattern in individuals with polymedicinal therapies and autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus.


This report demonstrated that the anti-RR pattern cannot be exclusively related to HCV and more studies are required to understand it.