<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-2025-987
Date of Submission: 2025-03-05

This report was submitted by a Other Healthcare Professional from Woodward Ltd Medical Center concerning patient ANON-PX-1535. The subject is a 23-year-old female with a significant medical history including migraines, anxiety, asthma, hypertension. 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): Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 465mg, initiated on 2025-02-15 for Hypertension and discontinued on 2025-02-27; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 373mg, initiated on 2025-02-15 for Hypothyroidism and discontinued on 2025-02-27.

On approximately 2025-02-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Nausea, Pruritus, Maculopapular Rash, Headache. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed else and advised read. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Risk girl around sport kid few. Source drop well effect student reach. Bill bring by news about.</data>
report_id: ADR-2025-987
report_date: '2025-03-05'
patient_details:
  patient_id: ANON-PX-1535
  gender: Female
  relevant_history:
  - migraines
  - anxiety
  - asthma
  - hypertension
  age_at_reaction: 23
suspected_drugs:
- drug_name: Lisinopril
  dosage: 465mg
  route_of_administration: Subcutaneous
  start_date: '2025-02-15'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-27'
- drug_name: Levothyroxine
  dosage: 373mg
  route_of_administration: Topical
  start_date: '2025-02-15'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-02-27'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-02-24'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed else and advised read.
- symptom_name: Nausea
  onset_date: '2025-02-24'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-02-24'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-24'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-02-24'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Woodward Ltd Medical Center
reporter_type: Other Healthcare Professional
notes: Risk girl around sport kid few. Source drop well effect student reach. Bill
  bring by news about.
