TRIM21 and interstitial lung disease: Patients with dual Ro52+/Ro60+ positivity exhibited significantly higher disease activity (median DAS28-ESR: 4.97 vs. 4.39, p = 0.002), worse functional status (median HAQ-DI: 0.88 vs. 0.63, p = 0.001), and increased systemic complications, notably interstitial lung disease (OR = 4.14, 95% CI: 1.71–10.68, p = 0.002) and hematologic involvement (OR = 2.50, 95% CI: 1.02–6.19, p = 0.044), compared to antibody-negative patients.