In vitro, inhibition of the synthesis of guanosine monophosphate (GMP) by various drugs such as ribavirin, acyclovir, azathioprine, and mycophenolic acid leads to the formation of subcellular structures in cultured cells. Autoantibodies targeting these cellular structures can be detected as “rods and rings” (RR) patterns by immunofluorescence. In vivo, autoantibodies to RR have been almost exclusively associated with hepatitis C virus patients treated with pegylated interferon-α and ribavirin. However, longitudinal data for other patient groups are scarce. Here, we reviewed 276 sequential immunofluorescence results from 127 patients with autoimmune hepatitis for the presence of RR patterns. Of 102 patients exposed to drugs known to induce RR in vitro, two patients under long-term azathioprine therapy were positive for this pattern. This is the first report of anti-RR in patients with autoimmune hepatitis and in patients treated with azathioprine.

在体外，各种药物如利巴韦林，阿昔洛韦，硫唑嘌呤和霉酚酸对鸟嘌呤单磷酸鸟苷（GMP）合成的抑制作用导致培养细胞中亚细胞结构的形成。靶向这些细胞结构的自身抗体可以通过免疫荧光检测为“棒和环”（RR）模式。在体内，针对RR的自身抗体几乎完全与使用聚乙二醇化干扰素-α和利巴韦林治疗的丙型肝炎病毒患者有关。但是，其他患者群体的纵向数据却很少。在这里，我们回顾了127例自身免疫性肝炎患者的RR谱图，并获得了276个连续免疫荧光结果。在102名暴露于已知可在体外诱发RR的药物的患者中，长期接受硫唑嘌呤治疗的两名患者对此模式呈阳性反应。这是自身免疫性肝炎患者和接受硫唑嘌呤治疗的患者中抗RR的首次报道。