<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-2025-969
Date of Submission: 2025-05-04

This report was submitted by a Patient from Tran LLC Medical Center concerning patient ANON-PX-7997. The subject is a 27-year-old other with a significant medical history including osteoarthritis, asthma, migraines, type 2 diabetes. 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 28mg, initiated on 2025-03-07 for Hypothyroidism and discontinued on 2025-04-27; Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 297mg, initiated on 2025-03-07 for Neuropathic pain and discontinued on 2025-04-27.

On approximately 2025-03-20, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Dizziness, Anaphylaxis, Somnolence, Pruritus. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed per and advised same. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed continue and advised trip. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Never yeah really say deal as alone. Third society sea system your might. Assume daughter perform both care.</data>
report_id: ADR-2025-969
report_date: '2025-05-04'
patient_details:
  patient_id: ANON-PX-7997
  gender: Other
  relevant_history:
  - osteoarthritis
  - asthma
  - migraines
  - type 2 diabetes
  age_at_reaction: 27
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 28mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-07'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-04-27'
- drug_name: Gabapentin
  dosage: 297mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-07'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-04-27'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-03-20'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed per and advised same.
- symptom_name: Dizziness
  onset_date: '2025-03-20'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-03-20'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-03-20'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed continue and advised trip.
- symptom_name: Pruritus
  onset_date: '2025-03-20'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Tran LLC Medical Center
reporter_type: Patient
notes: Never yeah really say deal as alone. Third society sea system your might. Assume
  daughter perform both care.
