<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-2024-378
Date of Submission: 2024-11-16

This report was submitted by a Physician from Freeman, Villanueva and Harper Medical Center concerning patient ANON-PX-4015. The subject is a 32-year-old female with a significant medical history including coronary artery disease, migraines, chronic kidney 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): Levothyroxine administered via the Topical route at a dosage of 303mg, initiated on 2024-09-02 for Hypothyroidism and discontinued on 2024-10-21; Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 369mg, initiated on 2024-09-02 for Hypertension and discontinued on 2024-10-21.

On approximately 2024-10-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Dizziness, Maculopapular Rash. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed bring and advised full. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed firm and advised fire. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 was calculated, The assessment concluded the relationship was 'Probable'. 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: While defense treat. Foot section sport.</data>
report_id: ADR-2024-378
report_date: '2024-11-16'
patient_details:
  patient_id: ANON-PX-4015
  gender: Female
  relevant_history:
  - coronary artery disease
  - migraines
  - chronic kidney disease
  age_at_reaction: 32
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 303mg
  route_of_administration: Topical
  start_date: '2024-09-02'
  indication_for_use: Hypothyroidism
  end_date: '2024-10-21'
- drug_name: Lisinopril
  dosage: 369mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-02'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-10-21'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-10-04'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-10-04'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed bring and advised full.
- symptom_name: Maculopapular Rash
  onset_date: '2024-10-04'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed firm and advised fire.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Freeman, Villanueva and Harper Medical Center
reporter_type: Physician
notes: While defense treat. Foot section sport.
