<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-2024-776
Date of Submission: 2024-10-28

This report was submitted by a Physician from Wallace and Sons Medical Center concerning patient ANON-PX-2047. The subject is a 40-year-old female with a significant medical history including migraines, seasonal allergies. 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 Oral route at a dosage of 251mg, initiated on 2024-09-04 for Hypothyroidism and discontinued on 2024-10-18.

On approximately 2024-10-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Nausea, Anaphylaxis, Diarrhea, Vomiting. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed thing and advised office. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-776
report_date: '2024-10-28'
patient_details:
  patient_id: ANON-PX-2047
  gender: Female
  relevant_history:
  - migraines
  - seasonal allergies
  age_at_reaction: 40
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 251mg
  route_of_administration: Oral
  start_date: '2024-09-04'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-10-18'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-10-15'
  severity: Mild
  outcome: Unknown
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-10-15'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed thing and advised office.
- symptom_name: Anaphylaxis
  onset_date: '2024-10-15'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-10-15'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-10-15'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 4
reporting_facility: Wallace and Sons Medical Center
reporter_type: Physician
