feat(records): surface structured allergies and family history in the doctor report and AI context

The structured Allergy / FamilyHistoryEntry stores reached FHIR export only: the doctor-report PDF shipped without the two sections every clinical intake asks for first, and the Coach knew allergies only from the free-text answer — a penicillin allergy recorded in the structured records UI never reached either surface. Doctor report: two new section toggles (allergies, familyHistory; both default ON, same stance as labs) across the prefs schema, the export selection, the aggregator, the PDF renderer, and the export panel. The tables render stored fields only — substance/category/kind/severity/ reaction/status and relationship/condition/age-at-onset; the reaction decrypts fail-soft per row and free-text notes are never read, matching the illness-journal stance. OpenAPI regenerated for the extended sections shape. Coach: the about-me context block now appends the structured rows as clearly labelled entries (authoritative over the free-text answer on conflict); the projection is a pure composer with unit tests. New section labels land in all six locales.
2026-11-09 21:10:59 +00:00 · 2026-07-05 17:54:32 +02:00
1 parent 8d36e69f75
commit 9b4f3ce56d
@@ -944,6 +944,10 @@ paths:
                      type: boolean
                    labs:
                      type: boolean
+                    allergies:
+                      type: boolean
+                    familyHistory:
+                      type: boolean
                locale:
                  type: string
                  enum:
@@ -1076,6 +1080,10 @@ paths:
                      type: boolean
                    labs:
                      type: boolean
+                    allergies:
+                      type: boolean
+                    familyHistory:
+                      type: boolean
                resourceTypes:
                  maxItems: 8
                  type: array
@@ -187,7 +187,18 @@
    "illnessColType": "Art",
    "illnessColLifecycle": "Verlauf",
    "illnessColOnset": "Beginn",
-    "illnessColResolved": "Abgeklungen"
+    "illnessColResolved": "Abgeklungen",
+    "allergiesTitle": "Allergien & Unverträglichkeiten",
+    "allergiesColSubstance": "Substanz",
+    "allergiesColCategory": "Kategorie",
+    "allergiesColKind": "Art",
+    "allergiesColSeverity": "Schweregrad",
+    "allergiesColReaction": "Reaktion",
+    "allergiesColStatus": "Status",
+    "familyHistoryTitle": "Familienanamnese",
+    "familyHistoryColRelationship": "Verwandtschaft",
+    "familyHistoryColCondition": "Erkrankung",
+    "familyHistoryColAgeAtOnset": "Alter bei Beginn"
  },
  "errorBoundary": {
    "title": "Da ist etwas schiefgelaufen",
@@ -5061,7 +5072,9 @@
      "fhirNote": "Die strukturierte Ausgabe folgt dem FHIR-R4-Standard (ePA-kompatibel).",
      "generate": "Erstellen",
      "error": "Export fehlgeschlagen ({code}).",
-      "labs": "Laborwerte"
+      "labs": "Laborwerte",
+      "allergies": "Allergien & Unverträglichkeiten",
+      "familyHistory": "Familienanamnese"
    },
    "globalExcludedInjectionSitesLabel": "Global ausgeschlossene Injektionsstellen",
    "globalExcludedInjectionSitesHint": "Hier gelistete Stellen werden für keine Medikation angeboten und beim Erfassen einer Dosis abgelehnt — auch wenn eine Medikation sie bevorzugt.",
@@ -187,7 +187,18 @@
    "illnessColType": "Type",
    "illnessColLifecycle": "Course",
    "illnessColOnset": "Onset",
-    "illnessColResolved": "Resolved"
+    "illnessColResolved": "Resolved",
+    "allergiesTitle": "Allergies & intolerances",
+    "allergiesColSubstance": "Substance",
+    "allergiesColCategory": "Category",
+    "allergiesColKind": "Kind",
+    "allergiesColSeverity": "Severity",
+    "allergiesColReaction": "Reaction",
+    "allergiesColStatus": "Status",
+    "familyHistoryTitle": "Family history",
+    "familyHistoryColRelationship": "Relative",
+    "familyHistoryColCondition": "Condition",
+    "familyHistoryColAgeAtOnset": "Age at onset"
  },
  "errorBoundary": {
    "title": "Something went wrong",
@@ -5061,7 +5072,9 @@
      "fhirNote": "The structured output follows the FHIR R4 standard (ePA-compatible).",
      "generate": "Generate",
      "error": "Export failed ({code}).",
-      "labs": "Lab results"
+      "labs": "Lab results",
+      "allergies": "Allergies & intolerances",
+      "familyHistory": "Family history"
    },
    "globalExcludedInjectionSitesLabel": "Globally excluded injection sites",
    "globalExcludedInjectionSitesHint": "Sites listed here are never offered for any medication and rejected when logging a dose, even if a medication prefers them.",
@@ -187,7 +187,18 @@
    "illnessColType": "Tipo",
    "illnessColLifecycle": "Curso",
    "illnessColOnset": "Inicio",
-    "illnessColResolved": "Resuelta"
+    "illnessColResolved": "Resuelta",
+    "allergiesTitle": "Alergias e intolerancias",
+    "allergiesColSubstance": "Sustancia",
+    "allergiesColCategory": "Categoría",
+    "allergiesColKind": "Tipo",
+    "allergiesColSeverity": "Gravedad",
+    "allergiesColReaction": "Reacción",
+    "allergiesColStatus": "Estado",
+    "familyHistoryTitle": "Antecedentes familiares",
+    "familyHistoryColRelationship": "Parentesco",
+    "familyHistoryColCondition": "Afección",
+    "familyHistoryColAgeAtOnset": "Edad de inicio"
  },
  "errorBoundary": {
    "title": "Algo ha salido mal",
@@ -5061,7 +5072,9 @@
      "fhirNote": "La salida estructurada sigue el estándar FHIR R4 (compatible con ePA).",
      "generate": "Generar",
      "error": "Error en la exportación ({code}).",
-      "labs": "Resultados de análisis"
+      "labs": "Resultados de análisis",
+      "allergies": "Alergias e intolerancias",
+      "familyHistory": "Antecedentes familiares"
    },
    "globalExcludedInjectionSitesLabel": "Sitios de inyección excluidos globalmente",
    "globalExcludedInjectionSitesHint": "Los sitios listados aquí no se ofrecen para ningún medicamento y se rechazan al registrar una dosis, aunque un medicamento los prefiera.",
@@ -187,7 +187,18 @@
    "illnessColType": "Type",
    "illnessColLifecycle": "Évolution",
    "illnessColOnset": "Début",
-    "illnessColResolved": "Résolue"
+    "illnessColResolved": "Résolue",
+    "allergiesTitle": "Allergies et intolérances",
+    "allergiesColSubstance": "Substance",
+    "allergiesColCategory": "Catégorie",
+    "allergiesColKind": "Type",
+    "allergiesColSeverity": "Sévérité",
+    "allergiesColReaction": "Réaction",
+    "allergiesColStatus": "Statut",
+    "familyHistoryTitle": "Antécédents familiaux",
+    "familyHistoryColRelationship": "Lien de parenté",
+    "familyHistoryColCondition": "Affection",
+    "familyHistoryColAgeAtOnset": "Âge au début"
  },
  "errorBoundary": {
    "title": "Une erreur est survenue",
@@ -5061,7 +5072,9 @@
      "fhirNote": "La sortie structurée suit la norme FHIR R4 (compatible ePA).",
      "generate": "Générer",
      "error": "Échec de l’export ({code}).",
-      "labs": "Résultats d'analyses"
+      "labs": "Résultats d'analyses",
+      "allergies": "Allergies et intolérances",
+      "familyHistory": "Antécédents familiaux"
    },
    "globalExcludedInjectionSitesLabel": "Sites d'injection exclus globalement",
    "globalExcludedInjectionSitesHint": "Les sites listés ici ne sont proposés pour aucun médicament et sont refusés lors de l'enregistrement d'une dose, même si un médicament les privilégie.",
@@ -187,7 +187,18 @@
    "illnessColType": "Tipo",
    "illnessColLifecycle": "Decorso",
    "illnessColOnset": "Inizio",
-    "illnessColResolved": "Risolta"
+    "illnessColResolved": "Risolta",
+    "allergiesTitle": "Allergie e intolleranze",
+    "allergiesColSubstance": "Sostanza",
+    "allergiesColCategory": "Categoria",
+    "allergiesColKind": "Tipo",
+    "allergiesColSeverity": "Gravità",
+    "allergiesColReaction": "Reazione",
+    "allergiesColStatus": "Stato",
+    "familyHistoryTitle": "Anamnesi familiare",
+    "familyHistoryColRelationship": "Parentela",
+    "familyHistoryColCondition": "Condizione",
+    "familyHistoryColAgeAtOnset": "Età di esordio"
  },
  "errorBoundary": {
    "title": "Qualcosa è andato storto",
@@ -5061,7 +5072,9 @@
      "fhirNote": "L’output strutturato segue lo standard FHIR R4 (compatibile ePA).",
      "generate": "Genera",
      "error": "Esportazione non riuscita ({code}).",
-      "labs": "Risultati degli esami"
+      "labs": "Risultati degli esami",
+      "allergies": "Allergie e intolleranze",
+      "familyHistory": "Anamnesi familiare"
    },
    "globalExcludedInjectionSitesLabel": "Siti di iniezione esclusi globalmente",
    "globalExcludedInjectionSitesHint": "I siti elencati qui non vengono proposti per alcun farmaco e vengono rifiutati al momento della registrazione di una dose, anche se un farmaco li preferisce.",
@@ -187,7 +187,18 @@
    "illnessColType": "Typ",
    "illnessColLifecycle": "Przebieg",
    "illnessColOnset": "Początek",
-    "illnessColResolved": "Ustąpiła"
+    "illnessColResolved": "Ustąpiła",
+    "allergiesTitle": "Alergie i nietolerancje",
+    "allergiesColSubstance": "Substancja",
+    "allergiesColCategory": "Kategoria",
+    "allergiesColKind": "Rodzaj",
+    "allergiesColSeverity": "Nasilenie",
+    "allergiesColReaction": "Reakcja",
+    "allergiesColStatus": "Status",
+    "familyHistoryTitle": "Wywiad rodzinny",
+    "familyHistoryColRelationship": "Pokrewieństwo",
+    "familyHistoryColCondition": "Schorzenie",
+    "familyHistoryColAgeAtOnset": "Wiek zachorowania"
  },
  "errorBoundary": {
    "title": "Coś poszło nie tak",
@@ -5061,7 +5072,9 @@
      "fhirNote": "Dane ustrukturyzowane są zgodne ze standardem FHIR R4 (kompatybilne z ePA).",
      "generate": "Generuj",
      "error": "Eksport nie powiódł się ({code}).",
-      "labs": "Wyniki badań"
+      "labs": "Wyniki badań",
+      "allergies": "Alergie i nietolerancje",
+      "familyHistory": "Wywiad rodzinny"
    },
    "globalExcludedInjectionSitesLabel": "Globalnie wykluczone miejsca iniekcji",
    "globalExcludedInjectionSitesHint": "Miejsca wymienione tutaj nie są proponowane dla żadnego leku i są odrzucane przy rejestrowaniu dawki, nawet jeśli lek je preferuje.",
@@ -58,6 +58,8 @@ interface SectionState {
  mood: boolean;
  bmi: boolean;
  labs: boolean;
+  allergies: boolean;
+  familyHistory: boolean;
 }

 const DEFAULT_SECTIONS: SectionState = {
@@ -79,6 +81,8 @@ const DEFAULT_SECTIONS: SectionState = {
  mood: false, // privacy default
  bmi: true,
  labs: true,
+  allergies: true,
+  familyHistory: true,
 };

 function buildSelectionSections(s: SectionState) {
@@ -106,6 +110,8 @@ function buildSelectionSections(s: SectionState) {
    mood: s.mood,
    bmi: s.bmi,
    labs: s.labs,
+    allergies: s.allergies,
+    familyHistory: s.familyHistory,
  };
 }

@@ -406,6 +412,16 @@ export function HealthRecordExportPanel() {
                  checked={sections.labs}
                  onToggle={() => toggle("labs")}
                />
+                <ToggleRow
+                  label={t("settings.healthRecord.allergies")}
+                  checked={sections.allergies}
+                  onToggle={() => toggle("allergies")}
+                />
+                <ToggleRow
+                  label={t("settings.healthRecord.familyHistory")}
+                  checked={sections.familyHistory}
+                  onToggle={() => toggle("familyHistory")}
+                />
              </div>

              {isPdfLike && (
@@ -19,6 +19,7 @@ vi.mock("@/lib/db", () => ({ prisma: {} }));
 import {
  clampPendingQuestions,
  composeSelfContextText,
+  composeStructuredRecordsText,
  deriveAgeYears,
  PENDING_QUESTION_MAX_CHARS,
  type SelfContext,
@@ -105,6 +106,52 @@ describe("composeSelfContextText", () => {
  });
 });

+describe("composeStructuredRecordsText", () => {
+  it("stays null when both structured stores are empty", () => {
+    expect(composeStructuredRecordsText([], [], "en")).toBeNull();
+  });
+
+  it("renders allergies from stored fields only (severity, reaction, non-active status)", () => {
+    const text = composeStructuredRecordsText(
+      [
+        {
+          substance: "Penicillin",
+          type: "ALLERGY",
+          severity: "SEVERE",
+          status: "ACTIVE",
+          reaction: "Anaphylaxis",
+        },
+        {
+          substance: "Lactose",
+          type: "INTOLERANCE",
+          severity: null,
+          status: "RESOLVED",
+          reaction: null,
+        },
+      ],
+      [],
+      "en",
+    );
+    expect(text).toContain("Penicillin (severe, reaction: Anaphylaxis)");
+    expect(text).toContain("Lactose (intolerance, resolved)");
+  });
+
+  it("renders family history with relationship labels and onset age (de)", () => {
+    const text = composeStructuredRecordsText(
+      [],
+      [
+        { relationship: "MOTHER", condition: "Typ-2-Diabetes", ageAtOnset: 55 },
+        { relationship: "FATHER", condition: "Hypertonie", ageAtOnset: null },
+      ],
+      "de",
+    );
+    expect(text).toContain("Familienanamnese");
+    expect(text).toContain("Mutter: Typ-2-Diabetes (Beginn mit 55)");
+    expect(text).toContain("Vater: Hypertonie");
+    expect(text).not.toContain("Vater: Hypertonie (");
+  });
+});
+
 describe("clampPendingQuestions", () => {
  it("caps at 3 questions and per-question length", () => {
    const long = "x".repeat(PENDING_QUESTION_MAX_CHARS + 50);
@@ -113,6 +113,155 @@ const GENDER_LABELS: Record<"de" | "en", Record<string, string>> = {
  en: { MALE: "male", FEMALE: "female", OTHER: "non-binary" },
 };

+/**
+ * v1.27.x — structured-record projection (link between the Anamnese
+ * stores and the AI context). A user who records a penicillin allergy in
+ * the structured records UI — the app's most explicit input for exactly
+ * this — must not have a Coach that only knows the free-text answer.
+ * Stored fields only, rendered descriptively; the structured rows are the
+ * deliberate record, so the block labels them as such and they take
+ * precedence over the free-text answer on conflict.
+ */
+
+export interface StructuredAllergyForPrompt {
+  substance: string;
+  type: string;
+  severity: string | null;
+  status: string;
+  reaction: string | null;
+}
+
+export interface StructuredFamilyHistoryForPrompt {
+  relationship: string;
+  condition: string;
+  ageAtOnset: number | null;
+}
+
+const ALLERGY_SEVERITY_LABELS: Record<"de" | "en", Record<string, string>> = {
+  de: {
+    NONE: "ohne Beschwerden",
+    MILD: "leicht",
+    MODERATE: "mittel",
+    SEVERE: "schwer",
+  },
+  en: {
+    NONE: "no symptoms",
+    MILD: "mild",
+    MODERATE: "moderate",
+    SEVERE: "severe",
+  },
+};
+
+const ALLERGY_STATUS_LABELS: Record<"de" | "en", Record<string, string>> = {
+  de: { INACTIVE: "inaktiv", RESOLVED: "abgeklungen" },
+  en: { INACTIVE: "inactive", RESOLVED: "resolved" },
+};
+
+const FAMILY_RELATIONSHIP_LABELS: Record<
+  "de" | "en",
+  Record<string, string>
+> = {
+  de: {
+    MOTHER: "Mutter",
+    FATHER: "Vater",
+    SISTER: "Schwester",
+    BROTHER: "Bruder",
+    DAUGHTER: "Tochter",
+    SON: "Sohn",
+    GRANDMOTHER_MATERNAL: "Großmutter (mütterlicherseits)",
+    GRANDFATHER_MATERNAL: "Großvater (mütterlicherseits)",
+    GRANDMOTHER_PATERNAL: "Großmutter (väterlicherseits)",
+    GRANDFATHER_PATERNAL: "Großvater (väterlicherseits)",
+    AUNT: "Tante",
+    UNCLE: "Onkel",
+    COUSIN: "Cousin/Cousine",
+    HALF_SIBLING: "Halbgeschwister",
+    OTHER: "Weitere Verwandte",
+  },
+  en: {
+    MOTHER: "mother",
+    FATHER: "father",
+    SISTER: "sister",
+    BROTHER: "brother",
+    DAUGHTER: "daughter",
+    SON: "son",
+    GRANDMOTHER_MATERNAL: "maternal grandmother",
+    GRANDFATHER_MATERNAL: "maternal grandfather",
+    GRANDMOTHER_PATERNAL: "paternal grandmother",
+    GRANDFATHER_PATERNAL: "paternal grandfather",
+    AUNT: "aunt",
+    UNCLE: "uncle",
+    COUSIN: "cousin",
+    HALF_SIBLING: "half-sibling",
+    OTHER: "other relative",
+  },
+};
+
+/**
+ * Compose the structured-records lines for the prompt context block.
+ * Descriptive, stored fields only — substance/kind/severity/reaction/
+ * status for allergies, relationship/condition/age-at-onset for family
+ * history. Returns `null` when both lists are empty so the caller can
+ * skip the block.
+ */
+export function composeStructuredRecordsText(
+  allergies: StructuredAllergyForPrompt[],
+  familyHistory: StructuredFamilyHistoryForPrompt[],
+  locale: string,
+): string | null {
+  const de = locale === "de";
+  const lang = de ? "de" : "en";
+  const lines: string[] = [];
+
+  if (allergies.length > 0) {
+    const items = allergies.map((a) => {
+      const details: string[] = [];
+      if (a.type === "INTOLERANCE") {
+        details.push(de ? "Unverträglichkeit" : "intolerance");
+      }
+      if (a.severity) {
+        const label = ALLERGY_SEVERITY_LABELS[lang][a.severity];
+        if (label) details.push(label);
+      }
+      if (a.reaction) {
+        details.push((de ? "Reaktion: " : "reaction: ") + a.reaction);
+      }
+      const statusLabel = ALLERGY_STATUS_LABELS[lang][a.status];
+      if (statusLabel) details.push(statusLabel);
+      return details.length > 0
+        ? `${a.substance} (${details.join(", ")})`
+        : a.substance;
+    });
+    lines.push(
+      (de
+        ? "Dokumentierte Allergien/Unverträglichkeiten (strukturierte Einträge — bei Widerspruch maßgeblich): "
+        : "Recorded allergies/intolerances (structured entries — authoritative on conflict): ") +
+        items.join("; "),
+    );
+  }
+
+  if (familyHistory.length > 0) {
+    const items = familyHistory.map((f) => {
+      const rel =
+        FAMILY_RELATIONSHIP_LABELS[lang][f.relationship] ?? f.relationship;
+      const onset =
+        f.ageAtOnset !== null
+          ? de
+            ? ` (Beginn mit ${f.ageAtOnset})`
+            : ` (onset at ${f.ageAtOnset})`
+          : "";
+      return `${rel}: ${f.condition}${onset}`;
+    });
+    lines.push(
+      (de
+        ? "Familienanamnese (strukturierte Einträge): "
+        : "Family history (structured entries): ") + items.join("; "),
+    );
+  }
+
+  return lines.length > 0 ? lines.join("\n") : null;
+}
+
 /**
 * Compose the merged self-context text the prompt block quotes: profile
 * facts first (age/gender from the User row — the single source, never
@@ -194,14 +343,33 @@ export async function getSelfContextTextForUser(
  locale: string,
 ): Promise<string | null> {
  try {
-    const [ctx, user] = await Promise.all([
+    const [ctx, user, allergyRows, familyRows] = await Promise.all([
      getSelfContextForUser(userId),
      prisma.user.findUnique({
        where: { id: userId },
        select: { dateOfBirth: true, gender: true },
      }),
+      // v1.27.x — structured records join the context block. Live rows
+      // only; the free-text notes are never selected. The reaction
+      // ciphertext decrypts fail-closed per row below.
+      prisma.allergy.findMany({
+        where: { userId, deletedAt: null },
+        orderBy: { createdAt: "asc" },
+        select: {
+          substance: true,
+          type: true,
+          severity: true,
+          status: true,
+          reactionEncrypted: true,
+        },
+      }),
+      prisma.familyHistoryEntry.findMany({
+        where: { userId, deletedAt: null },
+        orderBy: { createdAt: "asc" },
+        select: { relationship: true, condition: true, ageAtOnset: true },
+      }),
    ]);
-    return composeSelfContextText(
+    const selfText = composeSelfContextText(
      ctx,
      {
        ageYears: deriveAgeYears(user?.dateOfBirth ?? null),
@@ -209,6 +377,19 @@ export async function getSelfContextTextForUser(
      },
      locale,
    );
+    const recordsText = composeStructuredRecordsText(
+      allergyRows.map((r) => ({
+        substance: r.substance,
+        type: r.type,
+        severity: r.severity,
+        status: r.status,
+        reaction: decryptOrNull(r.reactionEncrypted),
+      })),
+      familyRows,
+      locale,
+    );
+    if (!selfText && !recordsText) return null;
+    return [selfText, recordsText].filter(Boolean).join("\n");
  } catch {
    return null;
  }
@@ -29,6 +29,7 @@ import type {
 } from "@/generated/prisma/client";
 import { pickCanonicalSourceRows } from "@/lib/analytics/source-priority";
 import { readNote } from "@/lib/crypto/note-cipher";
+import { decryptFromBytes } from "@/lib/ai/coach/bytes-codec";
 import { metricKeyForType } from "@/lib/measurements/cumulative-day-sum";
 import { userDayKey } from "@/lib/tz/resolver";
 import { resolveCanonicalRecovery } from "@/lib/insights/derived/recovery-resolve";
@@ -320,6 +321,46 @@ export interface DoctorReportData {
    /** ISO resolution instant, or null while ongoing. */
    resolvedAt: string | null;
  }> | null;
+  /**
+   * v1.27.x — structured allergy / intolerance records. Reference data,
+   * not time-windowed: populated whenever the `allergies` section toggle
+   * is ON (default) and the user recorded at least one live row. The
+   * reaction description is decrypted fail-soft per row (a key-rotation
+   * gap omits the value, never fails the report); the free-text note is
+   * NEVER read here — same stance as the illness journal. Null/absent
+   * otherwise; the PDF builder then skips the section. Optional so older
+   * fixtures still typecheck.
+   */
+  allergies?: Array<{
+    /** Substance / allergen label as the user recorded it. */
+    substance: string;
+    /** Category (FOOD / MEDICATION / ENVIRONMENT / BIOLOGIC / OTHER). */
+    category: string;
+    /** Kind (ALLERGY / INTOLERANCE). */
+    type: string;
+    /** Worst observed severity (NONE / MILD / MODERATE / SEVERE), or null. */
+    severity: string | null;
+    /** Status (ACTIVE / INACTIVE / RESOLVED). */
+    status: string;
+    /** Decrypted reaction description, or null (unset or key gap). */
+    reaction: string | null;
+  }> | null;
+  /**
+   * v1.27.x — structured family-history records. Reference data, not
+   * time-windowed: populated whenever the `familyHistory` section toggle
+   * is ON (default) and the user recorded at least one live row. Labels +
+   * onset age only — the free-text note is never read here. Null/absent
+   * otherwise; the PDF builder then skips the section. Optional so older
+   * fixtures still typecheck.
+   */
+  familyHistory?: Array<{
+    /** Relationship (MOTHER / FATHER / SISTER / …). */
+    relationship: string;
+    /** Condition label as the user recorded it. */
+    condition: string;
+    /** The relative's age at onset (years), or null when unknown. */
+    ageAtOnset: number | null;
+  }> | null;
 }

 /** The three persisted score types surfaced in the wellness summary. */
@@ -1410,6 +1451,58 @@ export async function collectDoctorReportData(
    illnessEpisodes = mapped.length > 0 ? mapped : null;
  }

+  // v1.27.x — structured allergies + family history. Reference data, not
+  // time-windowed (a penicillin allergy does not expire with the report
+  // window), so no date filter. Riding the section toggles keeps the "you
+  // can deselect any section" contract; both default ON — a clinical
+  // report without an allergy section is the riskier default. The
+  // reaction description decrypts fail-soft per row; the free-text notes
+  // are never selected, matching the illness-journal stance.
+  let allergies: DoctorReportData["allergies"] = null;
+  if (sections.allergies) {
+    const rows = await prisma.allergy.findMany({
+      where: { userId, deletedAt: null },
+      orderBy: { createdAt: "asc" },
+      select: {
+        substance: true,
+        category: true,
+        type: true,
+        severity: true,
+        status: true,
+        reactionEncrypted: true,
+      },
+    });
+    const mapped = rows.map((r) => {
+      let reaction: string | null = null;
+      if (r.reactionEncrypted && r.reactionEncrypted.byteLength > 0) {
+        try {
+          reaction = decryptFromBytes(r.reactionEncrypted);
+        } catch {
+          reaction = null;
+        }
+      }
+      return {
+        substance: r.substance,
+        category: r.category,
+        type: r.type,
+        severity: r.severity,
+        status: r.status,
+        reaction,
+      };
+    });
+    allergies = mapped.length > 0 ? mapped : null;
+  }
+
+  let familyHistory: DoctorReportData["familyHistory"] = null;
+  if (sections.familyHistory) {
+    const rows = await prisma.familyHistoryEntry.findMany({
+      where: { userId, deletedAt: null },
+      orderBy: { createdAt: "asc" },
+      select: { relationship: true, condition: true, ageAtOnset: true },
+    });
+    familyHistory = rows.length > 0 ? rows : null;
+  }
+
  return {
    period: {
      days,
@@ -1464,6 +1557,8 @@ export async function collectDoctorReportData(
    cycle,
    labResults,
    illnessEpisodes,
+    allergies,
+    familyHistory,
  };
 }

@@ -1604,6 +1604,121 @@ export function buildDoctorReportPdfDocument(
        .finalY + 8;
  }

+  // v1.27.x — structured allergy / intolerance records. Reference data
+  // (not time-windowed) the aggregator populates when the `allergies`
+  // toggle is ON (default) and rows exist. Stored fields only — substance,
+  // category, kind, severity, reaction, status — in the same calm factual
+  // table register as the illness section; no colour, no severity tint.
+  if (data.allergies && data.allergies.length > 0) {
+    y = ensureSpace(y, 6 + 18);
+    doc.setFontSize(14);
+    doc.setFont("helvetica", "bold");
+    doc.setTextColor(30, 30, 30);
+    doc.text(t("doctorReport.allergiesTitle"), margin, y);
+    y += 6;
+
+    const allergyRows = data.allergies.map((al) => [
+      al.substance,
+      t(`records.allergies.category.${al.category}`),
+      t(`records.allergies.type.${al.type}`),
+      al.severity ? t(`records.allergies.severity.${al.severity}`) : "—",
+      al.reaction ?? "—",
+      t(`records.allergies.status.${al.status}`),
+    ]);
+
+    autoTable(doc, {
+      startY: y,
+      head: [
+        [
+          t("doctorReport.allergiesColSubstance"),
+          t("doctorReport.allergiesColCategory"),
+          t("doctorReport.allergiesColKind"),
+          t("doctorReport.allergiesColSeverity"),
+          t("doctorReport.allergiesColReaction"),
+          t("doctorReport.allergiesColStatus"),
+        ],
+      ],
+      body: allergyRows,
+      theme: "grid",
+      styles: {
+        fontSize: 9,
+        cellPadding: 3,
+        textColor: [30, 30, 30],
+        lineColor: [200, 200, 200],
+        lineWidth: 0.3,
+      },
+      headStyles: {
+        fillColor: [245, 245, 245],
+        textColor: [30, 30, 30],
+        fontStyle: "bold",
+      },
+      alternateRowStyles: { fillColor: [252, 252, 252] },
+      margin: {
+        left: margin,
+        right: margin,
+        top: margin,
+        bottom: tableBottomMargin,
+      },
+    });
+    y =
+      (doc as jsPDF & { lastAutoTable: { finalY: number } }).lastAutoTable
+        .finalY + 8;
+  }
+
+  // v1.27.x — structured family-history records. Reference data the
+  // aggregator populates when the `familyHistory` toggle is ON (default)
+  // and rows exist. Relationship + condition + age at onset only — the
+  // free-text note never reaches this surface.
+  if (data.familyHistory && data.familyHistory.length > 0) {
+    y = ensureSpace(y, 6 + 18);
+    doc.setFontSize(14);
+    doc.setFont("helvetica", "bold");
+    doc.setTextColor(30, 30, 30);
+    doc.text(t("doctorReport.familyHistoryTitle"), margin, y);
+    y += 6;
+
+    const familyRows = data.familyHistory.map((fh) => [
+      t(`records.family.relationship.${fh.relationship}`),
+      fh.condition,
+      fh.ageAtOnset !== null ? String(fh.ageAtOnset) : "—",
+    ]);
+
+    autoTable(doc, {
+      startY: y,
+      head: [
+        [
+          t("doctorReport.familyHistoryColRelationship"),
+          t("doctorReport.familyHistoryColCondition"),
+          t("doctorReport.familyHistoryColAgeAtOnset"),
+        ],
+      ],
+      body: familyRows,
+      theme: "grid",
+      styles: {
+        fontSize: 9,
+        cellPadding: 3,
+        textColor: [30, 30, 30],
+        lineColor: [200, 200, 200],
+        lineWidth: 0.3,
+      },
+      headStyles: {
+        fillColor: [245, 245, 245],
+        textColor: [30, 30, 30],
+        fontStyle: "bold",
+      },
+      alternateRowStyles: { fillColor: [252, 252, 252] },
+      margin: {
+        left: margin,
+        right: margin,
+        top: margin,
+        bottom: tableBottomMargin,
+      },
+    });
+    y =
+      (doc as jsPDF & { lastAutoTable: { finalY: number } }).lastAutoTable
+        .finalY + 8;
+  }
+
  // v1.7.0 — optional AI summary. OUT of the clinical PDF by default;
  // rendered ONLY when the user explicitly opted in. Clearly labelled and
  // flagged as not clinically validated so a physician never mistakes it
@@ -92,6 +92,8 @@ describe("resolveDoctorReportPrefs", () => {
      sleep: false,
      cycle: false,
      labs: false,
+      allergies: false,
+      familyHistory: false,
    };
    const out = resolveDoctorReportPrefs(current, { mood: false });
    expect(out).toEqual({ ...current, mood: false });
@@ -33,6 +33,8 @@ export const doctorReportPrefsSchema = z
    sleep: z.boolean(),
    cycle: z.boolean(),
    labs: z.boolean(),
+    allergies: z.boolean(),
+    familyHistory: z.boolean(),
  })
  .partial();

@@ -53,6 +55,8 @@ export interface DoctorReportPrefs {
  sleep: boolean;
  cycle: boolean;
  labs: boolean;
+  allergies: boolean;
+  familyHistory: boolean;
 }

 /**
@@ -75,6 +79,12 @@ export const DEFAULT_DOCTOR_REPORT_PREFS: DoctorReportPrefs = {
  // Lab results the user recorded for exactly this purpose — sharing
  // bloodwork with a clinician. ON by default, like BP / weight.
  labs: true,
+  // Structured allergy / intolerance records — the section every clinical
+  // intake asks for first. Reference data recorded to share, ON by default
+  // like labs.
+  allergies: true,
+  // Structured family history — same stance as allergies.
+  familyHistory: true,
 };

 /**
@@ -77,6 +77,11 @@ export const exportSectionsSchema = z
    // Structured lab results — ON by default (recorded to share with a
    // clinician, same stance as BP / weight).
    labs: z.boolean(),
+    // Structured allergy / intolerance records — ON by default (the
+    // section every clinical intake asks for first; same stance as labs).
+    allergies: z.boolean(),
+    // Structured family history — ON by default, same stance as allergies.
+    familyHistory: z.boolean(),
  })
  .partial();

@@ -139,5 +144,7 @@ export function toDoctorReportPrefs(
    // Cycle is opt-in: only true when explicitly requested (privacy).
    cycle: s.cycle === true,
    labs: s.labs ?? fallback.labs,
+    allergies: s.allergies ?? fallback.allergies,
+    familyHistory: s.familyHistory ?? fallback.familyHistory,
  };
 }