TRIM21 and lymphopenia: Its positivity is considered a poor prognostic marker for inflammatory myopathy.[9] Studies show that double positivity for MDA5 and Ro-52 antibodies increases the risk of RIP-LD fivefold compared to single MDA5 positivity.[10] Additionally, double-positive patients exhibit higher lactic dehydrogenase, higher ferritin, lower albumin levels, lymphopenia and hypoxemia, leading to worse prognosis and higher mortality.