Vasculitic disorders
Red flags
Consider urgent referral for patients with the following
- Chest pain (angina/aortic dissection)
- New symptoms of claudication
- Subclavian steal
- New trophic vascular skin changes/incipient or frank gangrene
- Clinical suspicion of giant cell arteritis
Information that may lead to more urgent categorisation
- Renal involvement
- Significant proteinuria
- Worsening renal function
- Progressive severe symptoms
- Pulmonary symptoms
- Abdominal pain
- Severe rash
- Relapse of symptoms on medication
- Neurological symptoms
Conditions in this category are:
- Affecting large arteries
- Giant cell Arteries
- Takayasu’s arteries
- Aortitis in Coogan’s Syndrome
- Aortitis in spondyloarthropathies
- Isolated aortitis
- Medium-sized arteries
- Kawasaki’s disease
- Polyarteritis nodosa
- Small and medium-sized arteries
- ANCA-associated vasculitis
- Granulomatosis with polyangitis (Wegener’s granulomatosis)
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
- Primary angiitis of the CNS
- Small arteries
- IgA vasculitis (Henoch Schonlein purpura)
- Vasculitis related to rheumatoid disease, SLE and Sjogren’s syndrome
- Cryoglobulinaemic vasculitis
- Anti-GBM disease (Goodpasture’s disease)
- Drug induced vasculitis
- Arteries and veins of various sizes
- Behcet’s disease
- Relapsing polychondritis
Other important information for referring practitioners
Lifestyle changes
- Assist smoking cessation
- Advise on healthy diet and exercise
- Alcohol reduction
Medical Management
- Ensure patient is educated about their condition and has an action plan in case of red flags
- Monitor cardiovascular and renal function
- Monitor and control BP
Referral requirements
A referral may be rejected without the following information.
- Presence of any Red Flags (see below)
- Reason for referral and suspected diagnosis
- Timeline of symptoms
- Include severity of symptoms
- Main organs of involvement
- Evidence of renal involvement or cardiovascular involvement
- Include last 2-3 specialist letters if has been seen by another immunologist
- Treatments trialled and reasons for failure
- Current medications and allergies
- Significant other medical conditions
- FBC, ESR, CRP
- E/LFT
Additional referral information (useful for processing the referral)
- Blood testing supporting diagnosis
- ANCA, ANA, anti DNA Abs, ENA, Complement C3, C4
- MSU with urinary protein excretion
- Any vascular imaging especially if large vessels involved
- Tissue biopsy information if available
- ECG/ECHO if cardiac involvement is suspected
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