Antisynthetase syndrome

So MDA5 positivity is probably the stronger risk factor for ILD, and especially rapidly progressive ILD, especially when it is in combination with Rho52.

Antisynthetase antibodies also matters, but they are less common in children.

So one of the biggest shifts in modern JDM practice, I would say, is that the conversation about lung disease starts early and not after the child becomes, you know, breathless.

So I think this is what has changed more in our practice over the last 15 years.