<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-2025-319
Date of Submission: 2025-01-07

This report was submitted by a Other Healthcare Professional from Williams PLC Medical Center concerning patient ANON-PX-9449. The subject is a 60-year-old female with a significant medical history including migraines, asthma, chronic kidney disease, atrial fibrillation. 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): Ibuprofen (NSAID) administered via the Intravenous route at a dosage of 168mg, initiated on 2024-10-14 for Pain and inflammation with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Subcutaneous route at a dosage of 493mg, initiated on 2024-10-14 for Hypothyroidism with the course ongoing.

On approximately 2024-11-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Hepatotoxicity, Nausea, Diarrhea. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed me and advised sport. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Once where interesting think assume buy. Even rather table. Eye but enjoy cost way.</data>
report_id: ADR-2025-319
report_date: '2025-01-07'
patient_details:
  patient_id: ANON-PX-9449
  gender: Female
  relevant_history:
  - migraines
  - asthma
  - chronic kidney disease
  - atrial fibrillation
  age_at_reaction: 60
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 168mg
  route_of_administration: Intravenous
  start_date: '2024-10-14'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
- drug_name: Levothyroxine
  dosage: 493mg
  route_of_administration: Subcutaneous
  start_date: '2024-10-14'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-11-11'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-11'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed me and advised sport.
- symptom_name: Nausea
  onset_date: '2024-11-11'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-11-11'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 2
reporting_facility: Williams PLC Medical Center
reporter_type: Other Healthcare Professional
notes: Once where interesting think assume buy. Even rather table. Eye but enjoy cost
  way.
