<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-2025-273
Date of Submission: 2025-07-30

This report was submitted by a Other Healthcare Professional from Watkins-Graham Medical Center concerning patient ANON-PX-9721. The subject is a 19-year-old male with a significant medical history including osteoarthritis, asthma, coronary artery disease. 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 Oral route at a dosage of 42mg, initiated on 2025-06-04 for Pain and inflammation and discontinued on 2025-07-15.

On approximately 2025-06-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis, Diarrhea, Hepatotoxicity. 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 Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed world and advised lead. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity 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. The assessment concluded the relationship was 'Probable'. 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: Seem key protect three girl most.</data>
report_id: ADR-2025-273
report_date: '2025-07-30'
patient_details:
  patient_id: ANON-PX-9721
  gender: Male
  relevant_history:
  - osteoarthritis
  - asthma
  - coronary artery disease
  age_at_reaction: 19
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 42mg
  route_of_administration: Oral
  start_date: '2025-06-04'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-07-15'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-06-09'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-06-09'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-06-09'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed world and advised lead.
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-09'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Watkins-Graham Medical Center
reporter_type: Other Healthcare Professional
notes: Seem key protect three girl most.
