<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-2025-777
Date of Submission: 2025-07-19

This report was submitted by a Other Healthcare Professional from Ramirez PLC Medical Center concerning patient ANON-PX-9376. The subject is a 20-year-old female with a significant medical history including type 2 diabetes, anxiety, chronic kidney disease, seasonal allergies. 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 Subcutaneous route at a dosage of 401mg, initiated on 2025-05-23 for Hypothyroidism and discontinued on 2025-06-27; Sertraline (SSRI) administered via the Subcutaneous route at a dosage of 221mg, initiated on 2025-05-23 for Major depressive disorder and discontinued on 2025-06-27.

On approximately 2025-06-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Headache, Dizziness, Pruritus, Stevens-Johnson syndrome. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed against and advised edge. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed need and advised attention. The current patient status regarding this symptom is 'Recovering'. 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 'Not Recovered'. 

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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Get popular ground unit hair service.</data>
report_id: ADR-2025-777
report_date: '2025-07-19'
patient_details:
  patient_id: ANON-PX-9376
  gender: Female
  relevant_history:
  - type 2 diabetes
  - anxiety
  - chronic kidney disease
  - seasonal allergies
  age_at_reaction: 20
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 401mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-23'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-06-27'
- drug_name: Sertraline
  dosage: 221mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-23'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-06-27'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-06-22'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed against and advised edge.
- symptom_name: Headache
  onset_date: '2025-06-22'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Dizziness
  onset_date: '2025-06-22'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-06-22'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed need and advised attention.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-22'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 1
reporting_facility: Ramirez PLC Medical Center
reporter_type: Other Healthcare Professional
notes: Get popular ground unit hair service.
