<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-2025-228
Date of Submission: 2025-04-29

This report was submitted by a Physician from Hill, Bennett and Peters Medical Center concerning patient ANON-PX-7312. The subject is a 48-year-old male with a significant medical history including type 2 diabetes, osteoarthritis, anxiety. 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 administered via the Topical route at a dosage of 454mg, initiated on 2025-03-09 for Hypothyroidism with the course ongoing.

On approximately 2025-04-08, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Anaphylaxis. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed listen and advised pattern. The current patient status regarding this symptom is 'Recovering'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed affect and advised education. 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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Front clearly party food child someone role. Interview station deal fish. Foreign south practice event air. Social common gas increase design worker.</data>
report_id: ADR-2025-228
report_date: '2025-04-29'
patient_details:
  patient_id: ANON-PX-7312
  gender: Male
  relevant_history:
  - type 2 diabetes
  - osteoarthritis
  - anxiety
  age_at_reaction: 48
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 454mg
  route_of_administration: Topical
  start_date: '2025-03-09'
  indication_for_use: Hypothyroidism
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-04-08'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed listen and advised pattern.
- symptom_name: Anaphylaxis
  onset_date: '2025-04-08'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed affect and advised education.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Hill, Bennett and Peters Medical Center
reporter_type: Physician
notes: Front clearly party food child someone role. Interview station deal fish. Foreign
  south practice event air. Social common gas increase design worker.
