<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-2025-270
Date of Submission: 2025-04-29

This report was submitted by a Patient from Gross-Myers Medical Center concerning patient ANON-PX-1357. The subject is an adult female with a significant medical history including atrial fibrillation, osteoarthritis, coronary artery disease, 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): Ibuprofen administered via the Intravenous route at a dosage of 262mg, initiated on 2025-04-01 for Pain and inflammation and discontinued on 2025-04-22; Levothyroxine administered via the Intramuscular route at a dosage of 370mg, initiated on 2025-04-01 for Hypothyroidism and discontinued on 2025-04-22.

On approximately 2025-04-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Angioedema, Nausea, Pruritus. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed but and advised brother. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed manage and advised live. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed weight and advised idea. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 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: Left American discover hold development character. Successful president next quickly life.</data>
report_id: ADR-2025-270
report_date: '2025-04-29'
patient_details:
  patient_id: ANON-PX-1357
  gender: Female
  relevant_history:
  - atrial fibrillation
  - osteoarthritis
  - coronary artery disease
  - chronic kidney disease
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 262mg
  route_of_administration: Intravenous
  start_date: '2025-04-01'
  indication_for_use: Pain and inflammation
  end_date: '2025-04-22'
- drug_name: Levothyroxine
  dosage: 370mg
  route_of_administration: Intramuscular
  start_date: '2025-04-01'
  indication_for_use: Hypothyroidism
  end_date: '2025-04-22'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-04-06'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed but and advised brother.
- symptom_name: Angioedema
  onset_date: '2025-04-06'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed manage and advised live.
- symptom_name: Nausea
  onset_date: '2025-04-06'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-04-06'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed weight and advised idea.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 2
reporting_facility: Gross-Myers Medical Center
reporter_type: Patient
notes: Left American discover hold development character. Successful president next
  quickly life.
