Go to whole of WA Government Search
Pituitary Disorders Referral Access Criteria

Pituitary Disorders Referral Access Criteria

Referrers should use this page when referring patients to public paediatric endocrinology and diabetes outpatient services for pituitary disorders. This RAC is applicable to referrals for patients aged <16 years only.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Suspected pituitary mass with or without neurological symptoms and visual signs (e.g. headaches, visual field loss, blurred vision)
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate paediatric endocrinology assessment (seen within 7 days):
  • Nil

To contact the relevant service, see Clinician Assist WA: Acute Paediatric Assessment (external site)
Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Any signs of pituitary hormone deficiency affecting adrenals, growth, thyroid, puberty or water regulation
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Relevant history, onset, duration and severity of symptoms
  • Current medication list
  • Any known allergies
Examination
  • Serial measurements of height and weight (ideally 6-12 months) in a growth chart
  • Staging of puberty (delayed/arrested/pre-pubertal)
Investigations
  • Nil
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • U&E
  • LFT
  • TSH
  • T4
  • Insulin-like growth factor 1 (IGF-1)
  • Insulin-like growth factor binding protein 3 (IGF-BP3)
  • For those in pubertal age group: LH, FSH
  • Cerebral MRI with pituitary view
  • X-ray left hand for bone age
  • Early morning cortisol
Indicative clinical urgency category

Category 1

Appointment within 30 days
  • Follow up clinic from emergency presentation
  • Suspected pituitary hormone deficiency in those aged <2 years

Category 2

Appointment within 90 days
  • Any form of pituitary hormone deficiency in those aged >2 years

Category 3

Appointment within 365 days
  • No defined category 3 criteria
Exclusions
  • Nil
Useful information
  • See Australia and New Zealand Society for Endocrinology and Diabetes for clinical resources (external site)

Feedback

If you would like to submit feedback on the contents of the Referral Access Criteria, please complete this form.

Last reviewed: 18-03-2024
wa.gov.au