Autoimmunity disorders (including connective tissue disorders)Referral Access Criteria
Autoimmunity disorders (including connective tissue disorders)Referral Access Criteria
Referrers should use this page when referring patients to public adult immunology outpatient services for autoimmunity disorders (including connective tissues disorders).
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| 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. |
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate immunology assessment (seen within 7 days):
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- Active autoimmune disease with rapidly progressive end-organ damage
- Vasculitis with evidence of rapidly progressive end-organ damage
To contact the relevant service, please see Clinician Assist WA: Immunology assessment (external site).
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Systemic vasculitis
- Systemic autoimmune disorders such as SLE, Sjogren’s syndrome, dermatomyositis
- Systemic autoinflammatory diseases (e.g. adult-onset still’s disease, familiar Mediterranean fever, periodic fever syndromes)
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| Mandatory information |
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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.
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| History |
- Relevant history, onset, duration, and severity of symptoms
- Current medication list
- Any known allergies
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| Examination |
- Relevant physical findings (e.g. symptoms can range from fatigue, fever, malaise, arthralgia/arthritis, skin rash/lesions, alopecia)
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| Investigations |
- FBC
- U&Es
- LFTs
- ESR
- CRP
- MSU MC&S
- CK (if myositis suspected)
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| Highly desirable |
| History |
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| Examination |
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| Investigations |
- Relevant biopsy
- Relevant XR
- C3, C4
- ANA test
- ENA, anti-dsDNA if ANA positive
- ANCA test
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- Active autoimmune disease with evidence or concern regarding end organ dysfunction
- Connective Tissue Disease associated myositis
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Category 2
Appointment within 90 days
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- Assessment of suspected autoimmune disease without major end organ disease (e.g. Sjogren’s syndrome)
- Connective Tissue Disease on established treatment and stable
- Likely Connective Tissue Disease requiring assessment and management
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Category 3
Appointment within 365 days
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- Assessment of asymptomatic serum autoantibodies
- Connective Tissue Disease for exclusion with minimal symptoms
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| Exclusions |
- Other organ specific autoimmune conditions. Refer to relevant organ-based specialties:
- Type 1 diabetes mellitus
- Refer to endocrinology and diabetes
- Ehlers-Danlos syndrome or hypermobility spectrum disorder
- Coeliac disease
- Rheumatoid arthritis and other inflammatory arthritis syndromes
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