Previous studies reported that anti-Ro52 antibody positivity was associated with a symptomatic form of ILD [14], acute-onset ILD resistant to immunosuppressive treatments [15], and furthermore, RP-ILD and poor prognosis [14,16] in patients with anti-synthetase antibodies; however, the association between the presence of anti-Ro52 antibodies and unfavorable outcomes was not replicated in some studies [17,18], and controversy remains regarding the significance of anti-Ro52 antibody positivity in patients with anti-synthetase antibodies. Here, TRIM21 is linked to interstitial lung disease.