<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-2025-923
Date of Submission: 2025-04-21

This report was submitted by a Physician from Ramirez, Braun and Davis Medical Center concerning patient ANON-PX-6743. The subject is a 82-year-old other with a significant medical history including migraines, type 2 diabetes, 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 administered via the Oral route at a dosage of 96mg, initiated on 2025-03-08 for Hypothyroidism with the course ongoing.

On approximately 2025-04-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Anaphylaxis, Nausea, Angioedema, Vomiting. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed student and advised poor. The current patient status regarding this symptom is 'Recovering'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed number and advised space. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, The assessment concluded the relationship was 'Probable'. 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: Apply maintain born reach example general everything. General society career without Mr none. Eight culture such heavy hand just. Week born yeah compare before.</data>
report_id: ADR-2025-923
report_date: '2025-04-21'
patient_details:
  patient_id: ANON-PX-6743
  gender: Other
  relevant_history:
  - migraines
  - type 2 diabetes
  - chronic kidney disease
  age_at_reaction: 82
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 96mg
  route_of_administration: Oral
  start_date: '2025-03-08'
  indication_for_use: Hypothyroidism
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-04-01'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed student and advised poor.
- symptom_name: Anaphylaxis
  onset_date: '2025-04-01'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-04-01'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed number and advised space.
- symptom_name: Angioedema
  onset_date: '2025-04-01'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-04-01'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 7
reporting_facility: Ramirez, Braun and Davis Medical Center
reporter_type: Physician
notes: Apply maintain born reach example general everything. General society career
  without Mr none. Eight culture such heavy hand just. Week born yeah compare before.
