Queensland Government
Queensland Government
Home / Refer your patient / Immunology / Allergic conditions

Allergic conditions

Red flags

Consider urgent referral for patients with the following

  • Anaphylaxis for investigation.

Information That May Lead to More Urgent Categorisation

  • Most cases where an anaphylactic reaction has recently occurred will be category 1

Referral for allergic conditions is usually for diagnosis and management. The GP will often be required to take an active part in the management if desensitisation therapy is used.

In scope conditions:

  • Angiooedema
    • Consider ACE inhibitor induced angioedema in patients treated with ACE inhibitors, even if these agents have been tolerated long term
  • Drug Allergy
  • IgE mediated food allergy
    • IgE-mediated reactions to food are associated with the onset of allergic features such as urticaria, angioedema or respiratory compromise within 60 minutes of food ingestion.
  • Antibiotic allergy
  • Urticaria/hives
    • Non-urticarial rashes should be referred to Dermatology

Other Conditions:

  • Anaesthetic allergy
    • Multiple services exist across Queensland. Clinical Immunology recommends that referrers liaise with local providers. Find your nearest testing centre: Testing Centres – ANZAAG.
  • Food intolerance
  • Respiratory allergy (generally refer to Thoracic Medicine)
  • Mast cell activation syndrome (MCAS)
    • Further information is required to accept these referrals – please essential referral information below

Out of scope conditions:

  • Asthma – Please refer to Respiratory or asthma clinic, however referrals will be accepted from respiratory physicians for collaborative management.
  • Atopic dermatitis/eczema – referrals will only be accepted from a Dermatologist for collaborative management
  • Non-allergic rhinonsinusitis – best evaluated by ENT. Referrals will only be accepted from an ENT Surgeon for collaborative management.
  • Itch without rash
  • Eosinophilic oesophagitis – please refer to gastroenterology, however referrals will be accepted from gastroenterologists for collaborative management

Other important information for referring practitioners

Lifestyle changes

  • Allergen avoidance
    • Dust reduction
    • Air filters in air conditioning units and vacuum cleaners
    • Reduced carpets and soft furnishings that may trap dust
  • Advise on Medic Alert (bracelet, pendant)

Medical management

  • Ensure the availability of an epipen if anaphylaxis has occurred
    • Provide information on anaphylaxis action plan (see link below)
  • Careful history taking will often narrow down the possible allergens
  • Advise patients with intermittent rash to take photos which may help in diagnosis
  • Use diet and symptom diary to help identify food allergies
  • RAST testing is expensive and if performed should be targeted specifically at the most likely allergens. Do not perform blanket testing.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Reason for referral
  • List of symptoms and timeline
    • Include frequency and severity of symptoms as these are important for accurate triage
  • Suspected or proven allergens
  • List significant medical conditions
  • Medication trialled and reasons for failure
  • Current medications and known allergies – please note that an up to date medication list is essential

Allergic rhinitis/rhinosinusitis

  • Please provide details of trialled medical management (i.e antihistamines, intranasal corticosteroid sprays) with the referral. Referrals will not be accepted without this detail.
  • Referrals for continuation of desensitisation commenced by another practitioner will not be accepted.
  • Referrals for desensitisation for animal danders or moulds will not be accepted unless there is an occupational requirement associated with dander exposure.

Drug Allergy

  • Please provide details of implicated agent, details of reaction and clinical need.
  • Referrals for recognised medication adverse effects or non-immunologic reactions are not accepted.

Antibiotic allergy

  • Please provide details of implicated agents, alternatives tolerated (e.g if the patient is penicillin allergic have cephalosporins been tolerated) and clinical need.

Mast cell activation syndrome (MCAS)

  • Please provide:
    • Clinical features of severe, recurrent (episodic) systemic symptoms consistent with mast cell mediator release (urticaria, angioedema, anaphylaxis)
    • Documented increase in mast cell mediator levels – serum tryptase is the only clinically validated test available currently.
    • Clinical improvement with mediator blockers I.e antihistamines.

Urticaria/hives

  • Please provide details of treatment to date

Food intolerance

  • Referrals will not be accepted without clinical details suggestive of allergy.

Additional referral information (useful for processing the referral)

  • Eosinophil count
  • Total IgE
  • FBC, CRP, Chem20, thyroid function tests
  • Skin prick testing if available
  • Skin biopsy results if performed
  • Imaging if previously performed including CXR
  • For suspected food related reactions: specific IgE/RAST to suspected food(s). Food mix testing is of limited utility and should not be routinely performed in assessment of food allergy.
  • Serum tryptase (random)
  • C3/C4 and C1-esterase inhibitor level/function for angioedema

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Back to top