Immunodeficiency disorders
Red flags
Consider urgent referral for patients with the following
- Severe sepsis
Conditions in this category include:
- Chronic granulomatous disease (neutrophil deficiency)
- Common variable immunodeficiency
- Deficiency of antibodies (presents with recurrent chest and sinus infection)
- DiGeorge syndrome (Thymic aplasia and facial abnormalities)
- Selective IgA deficiency (presents with sinusitis , respiratory, GIT and urinary tract infections
- Severe combined immunodeficiency (presents in infancy, requires bone marrow transplant as deficiency of T cells and antibodies)
- X-Linked agammaglobulinaemia (presents in infancy)
- Hereditary angioedema
Most of these disorders are rare and referral will usually be for continuing management when patients move area. Ensure that if seen by a previous specialist, copies of the last 2-3 letters are included.
Other important information for referring practitioners
Lifestyle changes
- Advise healthy lifestyle
- Advise immunisation where appropriate
Medical management
- Management of patients with immunodeficiency requires close communication between primary care physicians and hospital specialists.
- Ensure vaccinations where appropriate (DO NOT administer live attenuated viral vaccines, obtain expert advice)
- Provide patients with acute sepsis action plans
- Consider this diagnosis especially in the young presenting with bacterial infections (ear, sinus, chest)
Referral requirements
A referral may be rejected without the following information.
- Presence of any Red Flags
- Reason for referral
- Immunodeficiency condition if known
- Timeline and severity of any complications
- Predisposing infections
- Include copies of last 2-3 letters if previously seen by immunologist
- List other medical conditions
- Family history
- Current medication and allergies
- Immunisation history
- Blood testing confirming diagnosis
- FBC, E/LFTs
Additional referral information (useful for processing the referral)
- Bone marrow analysis
- Blood cultures
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.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org