<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-2025-666
Date of Submission: 2025-08-02

This report was submitted by a Other Healthcare Professional from Moreno, Randolph and Prince Medical Center concerning patient ANON-PX-5669. The subject is a 38-year-old female with a significant medical history including seasonal allergies, asthma, coronary artery 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 218mg, initiated on 2025-07-21 for Hypothyroidism and discontinued on 2025-07-30.

On approximately 2025-07-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash, Hepatotoxicity, Vomiting. 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 'Recovered'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 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 Vomiting was classified as Moderate 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. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Board to cost young game fast. Where throw Congress behavior why.</data>
report_id: ADR-2025-666
report_date: '2025-08-02'
patient_details:
  patient_id: ANON-PX-5669
  gender: Female
  relevant_history:
  - seasonal allergies
  - asthma
  - coronary artery disease
  age_at_reaction: 38
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 218mg
  route_of_administration: Topical
  start_date: '2025-07-21'
  indication_for_use: Hypothyroidism
  end_date: '2025-07-30'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-07-23'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-07-23'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-07-23'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-07-23'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Moreno, Randolph and Prince Medical Center
reporter_type: Other Healthcare Professional
notes: Board to cost young game fast. Where throw Congress behavior why.
