<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-2024-874
Date of Submission: 2024-11-15

This report was submitted by a Physician from Beltran PLC Medical Center concerning patient ANON-PX-1098. The subject is an adult male with a significant medical history including migraines, coronary artery disease, 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 Topical route at a dosage of 383mg, initiated on 2024-08-26 for Hypothyroidism with the course ongoing.

On approximately 2024-10-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Nausea. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea 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. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Full enter hand. Left think green might ability rest leg.</data>
report_id: ADR-2024-874
report_date: '2024-11-15'
patient_details:
  patient_id: ANON-PX-1098
  gender: Male
  relevant_history:
  - migraines
  - coronary artery disease
  - chronic kidney disease
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 383mg
  route_of_administration: Topical
  start_date: '2024-08-26'
  indication_for_use: Hypothyroidism
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-10-01'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-10-01'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 6
reporting_facility: Beltran PLC Medical Center
reporter_type: Physician
notes: Full enter hand. Left think green might ability rest leg.
