A recent study by Xu et al. reported that anti-Ro52 antibody is highly prevalent in anti-MDA5 antibody-positive CADM with ILD, and dual positivity for anti-Ro52 and anti-MDA5 antibody is associated with increased frequency of RP-ILD and lower survival rate in adults [17]. Here, TRIM21 is linked to clinically amyopathic dermatomyositis.