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The anti-synthetase syndrome is represented by the association of in-flammatory myopathy (polymyositis/dermatomyositis), interstitial pneu-monitis, Raynaud’s syndrome, inflammatory polyarthritis, and characteristic skin abnormalities. We found also a clinical aspects of Mechanic’s hand with high level of anti-synthetases. We report the case of a 66-year-old patient with polyar- thralgias of large and small inflammatory joints, myositis, Raynaud’s phenomenon, and cutaneous involvement of the hands and feet, with fissure hyperkeratosis feet and an appearance of mechanic’s hands. The patient had an inflammatory syndrome, elevated muscle enzymes, positivity of anti-Jo1 antibodies, PID at chest CT and the presence of inflammatory mononuclear cell infiltrates at muscle biopsy. The evolution under immunosuppressive treatment combining corticosteroids and methotrexate was marked by an oedemato-ascitic decompensation of a post-HVB cirrhosis unknown.