<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2024-823
Date of Submission: 2024-10-21

This report was submitted by a Physician from Hall Inc Medical Center concerning patient ANON-PX-3351. The subject is a 47-year-old male with a significant medical history including migraines, chronic kidney disease, asthma. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 18mg, initiated on 2024-09-18 for Hypothyroidism and discontinued on 2024-10-05.

On approximately 2024-09-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Anaphylaxis, Hepatotoxicity. The Diarrhea was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed song and advised movie. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-823
report_date: '2024-10-21'
patient_details:
  patient_id: ANON-PX-3351
  gender: Male
  relevant_history:
  - migraines
  - chronic kidney disease
  - asthma
  age_at_reaction: 47
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 18mg
  route_of_administration: Intramuscular
  start_date: '2024-09-18'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-10-05'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-09-23'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2024-09-23'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-09-23'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed song and advised movie.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 6
reporting_facility: Hall Inc Medical Center
reporter_type: Physician
