SITUS INVERSUS TOTALIS WITH HCV- A RARE ASSOCIATION

AbstractIntroduction: Situs inversus totalis is rare but compatible with life when not associated with pathologies likeprimary ciliary dyskinesia. It is having unknown aetiology but may be associated with certain cardiopulmonary conditions.Patients are usually diagnosed with situs inversus during evaluation for other medical conditions as in our case report wherepatient was being evaluated for chronic HCV infection. Patients diagnosed with this condition must be counselled andreassured that they can live a normal life.Case report: Afourty five-year-old female having non-significant past history, was detected to be sufferingfromchronichepatitis C virus (HCV) infection on routine screening. On detailed evaluation, she was found to be having Situs inversustotalis as evidenced by Chest X-ray, ECG, Ultrasonogram abdomen and Fibroscan. The HCV RNA quantitative load was13556 I.U./ml with mildhyperbilirubinemia and transaminitis. The ultrasound abdomen revealed mild hepatomegaly andliver on left side and spleen on right side. The chest x-ray showed left ventricular apex on left side, trachea deviated to leftside, right lung which is wide and short on left side, gastric bubble on right side and left diaphragm was raised due toprescence of liver on left side. The ECG showed classical severe right sided deviation, inversion of P, QRS complex and Twave in lead 1, upright QRS complex in AVR lead and poor progression of R wave in V1-V6 chest leads. She had noevidence of cirrhosis but significant fibrosis as evidenced by Fibroscan score of 9 Kpa. There were no complaints regardingchest, cardiovascular, abdominal or neurological system. She was given antiviral treatment with sofosbuvir 400 mg &Daclatasvir 60 mg for total of 12 weeks duration and achieved sustained virological response (SVR) after 12 weeks ofcompletion of treatment., as evidenced by complete absence of HCV RNA on polymerase chain testing (PCR) report. Shehas been followed for one and year and repeat HCV RNA test and clinical examination for relapse is non-contributory.Conclusion:Our case report is a rare in which situs inversus totalis is seen in HCV patient. There is rare case report of thesame in literature. There is any association between the two or is a co-incidental finding, is further area of research.