<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-2025-677
Date of Submission: 2025-08-07

This report was submitted by a Pharmacist from Marshall PLC Medical Center concerning patient ANON-PX-1371. The subject is an adult other with a significant medical history including seasonal allergies, chronic kidney disease, osteoarthritis. 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 Intravenous route at a dosage of 338mg, initiated on 2025-06-12 for Hypothyroidism and discontinued on 2025-07-17; Ibuprofen administered via the Oral route at a dosage of 191mg, initiated on 2025-06-12 for Pain and inflammation and discontinued on 2025-07-17.

On approximately 2025-07-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Dizziness, Somnolence, Pruritus, Anaphylaxis. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed product and advised sign. The current patient status regarding this symptom is 'Recovered'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed by and advised recent. The current patient status regarding this symptom is 'Recovered'. 

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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Movie national guess her pull later commercial. Him maintain respond edge pass billion network bed.</data>
report_id: ADR-2025-677
report_date: '2025-08-07'
patient_details:
  patient_id: ANON-PX-1371
  gender: Other
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - osteoarthritis
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 338mg
  route_of_administration: Intravenous
  start_date: '2025-06-12'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-07-17'
- drug_name: Ibuprofen
  dosage: 191mg
  route_of_administration: Oral
  start_date: '2025-06-12'
  indication_for_use: Pain and inflammation
  end_date: '2025-07-17'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-07-15'
  severity: Severe
  outcome: Fatal
  intervention_required: true
- symptom_name: Dizziness
  onset_date: '2025-07-15'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-07-15'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed product and advised sign.
- symptom_name: Pruritus
  onset_date: '2025-07-15'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-07-15'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed by and advised recent.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Marshall PLC Medical Center
reporter_type: Pharmacist
notes: Movie national guess her pull later commercial. Him maintain respond edge pass
  billion network bed.
