<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-2024-379
Date of Submission: 2024-09-19

This report was submitted by a Other Healthcare Professional from Myers and Sons Medical Center concerning patient ANON-PX-2232. The subject is a 43-year-old other with a significant medical history including seasonal allergies, type 2 diabetes, coronary artery 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): Levothyroxine administered via the Subcutaneous route at a dosage of 88mg, initiated on 2024-07-01 for Hypothyroidism and discontinued on 2024-09-15.

On approximately 2024-08-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Angioedema, Maculopapular Rash, Nausea, Diarrhea. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Moderate 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. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed go and advised body. The current patient status regarding this symptom is 'Unknown'. The Diarrhea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-379
report_date: '2024-09-19'
patient_details:
  patient_id: ANON-PX-2232
  gender: Other
  relevant_history:
  - seasonal allergies
  - type 2 diabetes
  - coronary artery disease
  - atrial fibrillation
  age_at_reaction: 43
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 88mg
  route_of_administration: Subcutaneous
  start_date: '2024-07-01'
  indication_for_use: Hypothyroidism
  end_date: '2024-09-15'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-29'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-08-29'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-29'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-08-29'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed go and advised body.
- symptom_name: Diarrhea
  onset_date: '2024-08-29'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 1
reporting_facility: Myers and Sons Medical Center
reporter_type: Other Healthcare Professional
