<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-2024-825
Date of Submission: 2024-10-30

This report was submitted by a Physician from Johnson-Hooper Medical Center concerning patient ANON-PX-8247. The subject is a 76-year-old male with a significant medical history including chronic kidney disease, hypertension, atrial fibrillation, 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 (Thyroid hormone) administered via the Oral route at a dosage of 310mg, initiated on 2024-08-31 for Hypothyroidism and discontinued on 2024-09-05.

On approximately 2024-09-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Headache, Pruritus. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed too and advised letter. The current patient status regarding this symptom is 'Not Recovered'. The Headache 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 scientist and advised age. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, 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. 

</data>
report_id: ADR-2024-825
report_date: '2024-10-30'
patient_details:
  patient_id: ANON-PX-8247
  gender: Male
  relevant_history:
  - chronic kidney disease
  - hypertension
  - atrial fibrillation
  - coronary artery disease
  age_at_reaction: 76
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 310mg
  route_of_administration: Oral
  start_date: '2024-08-31'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-09-05'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-09-05'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed too and advised letter.
- symptom_name: Headache
  onset_date: '2024-09-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-09-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed scientist and advised age.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 5
reporting_facility: Johnson-Hooper Medical Center
reporter_type: Physician
