<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-2025-404
Date of Submission: 2025-04-30

This report was submitted by a Patient from Davis-Williams Medical Center concerning patient ANON-PX-6714. The subject is an adult male with a significant medical history including chronic kidney disease, asthma, hypertension. 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 73mg, initiated on 2025-03-07 for Hypothyroidism and discontinued on 2025-04-29; Ibuprofen (NSAID) administered via the Intravenous route at a dosage of 473mg, initiated on 2025-03-07 for Pain and inflammation and discontinued on 2025-04-29.

On approximately 2025-04-26, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Pruritus, Angioedema, Maculopapular Rash. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed mean and advised close. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Treat tend rock same two skill Congress. Affect view police service several short police. Anyone similar indicate throw man sing.</data>
report_id: ADR-2025-404
report_date: '2025-04-30'
patient_details:
  patient_id: ANON-PX-6714
  gender: Male
  relevant_history:
  - chronic kidney disease
  - asthma
  - hypertension
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 73mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-07'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-04-29'
- drug_name: Ibuprofen
  dosage: 473mg
  route_of_administration: Intravenous
  start_date: '2025-03-07'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-04-29'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-26'
  severity: Mild
  outcome: Recovering
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-04-26'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed mean and advised close.
- symptom_name: Angioedema
  onset_date: '2025-04-26'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-04-26'
  severity: Severe
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 1
reporting_facility: Davis-Williams Medical Center
reporter_type: Patient
notes: Treat tend rock same two skill Congress. Affect view police service several
  short police. Anyone similar indicate throw man sing.
