<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-2024-848
Date of Submission: 2024-09-10

This report was submitted by a Nurse from Hopkins-Gonzalez Medical Center concerning patient ANON-PX-1282. The subject is a 50-year-old other with a significant medical history including seasonal allergies, 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): Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 102mg, initiated on 2024-08-04 for Hypertension and discontinued on 2024-08-26.

On approximately 2024-08-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Hepatotoxicity, Angioedema. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed ask and advised into. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Angioedema 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 9 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. 

</data>
report_id: ADR-2024-848
report_date: '2024-09-10'
patient_details:
  patient_id: ANON-PX-1282
  gender: Other
  relevant_history:
  - seasonal allergies
  - coronary artery disease
  age_at_reaction: 50
suspected_drugs:
- drug_name: Lisinopril
  dosage: 102mg
  route_of_administration: Subcutaneous
  start_date: '2024-08-04'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-08-26'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-08-16'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed ask and advised into.
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-16'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-08-16'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 9
reporting_facility: Hopkins-Gonzalez Medical Center
reporter_type: Nurse
