<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-2025-979
Date of Submission: 2025-07-15

This report was submitted by a Other Healthcare Professional from White, Daniel and Wang Medical Center concerning patient ANON-PX-6101. The subject is an adult other with a significant medical history including anxiety, asthma. 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): Lisinopril (ACE inhibitor) administered via the Topical route at a dosage of 34mg, initiated on 2025-04-22 for Hypertension with the course ongoing; Ibuprofen (NSAID) administered via the Subcutaneous route at a dosage of 458mg, initiated on 2025-04-22 for Pain and inflammation with the course ongoing.

On approximately 2025-06-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Anaphylaxis. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Mild 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 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Fire reflect cold many under democratic. Factor size owner along. Near nice short upon situation so reveal. Everyone until indeed almost sign herself quite.</data>
report_id: ADR-2025-979
report_date: '2025-07-15'
patient_details:
  patient_id: ANON-PX-6101
  gender: Other
  relevant_history:
  - anxiety
  - asthma
suspected_drugs:
- drug_name: Lisinopril
  dosage: 34mg
  route_of_administration: Topical
  start_date: '2025-04-22'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
- drug_name: Ibuprofen
  dosage: 458mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-22'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-06-07'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-06-07'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 10
reporting_facility: White, Daniel and Wang Medical Center
reporter_type: Other Healthcare Professional
notes: Fire reflect cold many under democratic. Factor size owner along. Near nice
  short upon situation so reveal. Everyone until indeed almost sign herself quite.
