Acquired/primary immunodeficiency disorders Referral Access Criteria
Acquired/primary immunodeficiency disorders Referral Access Criteria
Referrers should use this page when referring patients to public adult immunology outpatient services for acquired/primary immunodeficiency 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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To contact the relevant service, please see Clinician Assist WA: Immunology Requests (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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- Unusual infections (e.g. fungal, PJP, severe invasive bacterial infection)
- Family history of primary immunodeficiency (e.g. first degree relatives, extended family)
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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 including:
- History of severe/recurrent infections (e.g. >3 proven bacterial infections within one year)
- Details of previous treatment and outcome
- Familial history
- Current medication list
- Any known allergies
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| Examination |
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| Investigations |
- FBC
- Microbiology (e.g. swabs MCS, cultures)
- Serum IgA
- Serum IgM
- Serum IgG
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| Highly desirable |
| History |
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| Examination |
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| Investigations |
- CXR or CT chest (if history of recurrent chest infections)
- Serum IgG1, IgG2, IgG3 and IgG4
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- Primary immunodeficiency with clinical syndrome indicating organ involvement (e.g. bronchiectasis, enteropathy) or serious infection
- Unusual infections (e.g. fungal, PJP, severe invasive bacterial infection)
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Category 2
Appointment within 90 days
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- Assessment for non-HIV immunodeficiency without active clinical syndrome
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Category 3
Appointment within 365 days
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- No defined category 3 criteria
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| Useful information |
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- If referring primarily for bronchiectasis
- If referring for HIV, send as immediate referral direct to site
- See MBS: Item 71066 (external site), MBS: Item 71068 (external site), MBS: Item 71072 (external site) for information on accessing mandatory serum IgA, IgM and IgG investigations
- See MBS: Item 71073 (external site) for information on accessing highly desirable investigations of serum IgG subclasses
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