<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-2024-202
Date of Submission: 2024-12-30

This report was submitted by a Physician from King-Smith Medical Center concerning patient ANON-PX-1649. The subject is a 19-year-old female with a significant medical history including type 2 diabetes, seasonal allergies, asthma, 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 (Thyroid hormone) administered via the Oral route at a dosage of 377mg, initiated on 2024-10-04 for Hypothyroidism and discontinued on 2024-11-30.

On approximately 2024-11-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Hepatotoxicity, Maculopapular Rash. The Stevens-Johnson syndrome was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Cut run own fast population. Sense allow either you event measure third at.</data>
report_id: ADR-2024-202
report_date: '2024-12-30'
patient_details:
  patient_id: ANON-PX-1649
  gender: Female
  relevant_history:
  - type 2 diabetes
  - seasonal allergies
  - asthma
  - chronic kidney disease
  age_at_reaction: 19
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 377mg
  route_of_administration: Oral
  start_date: '2024-10-04'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-11-30'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-18'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-18'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-18'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: King-Smith Medical Center
reporter_type: Physician
notes: Cut run own fast population. Sense allow either you event measure third at.
