Chronic urticaria Referral Access Criteria

Referrers should use this page when referring patients to public adult immunology outpatient services for chronic urticaria.

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.
Airway compromising angioedema

Immediate referral
Immediately contact on-call registrar or service to arrange immediate immunology assessment (seen within 7 days):
Nil To contact the relevant service, please see Clinician Assist WA: Immunology requests (external site).

Immediate referral

Immediately contact on-call registrar or service to arrange immediate immunology assessment (seen within 7 days):

To contact the relevant service, please see Clinician Assist WA: Immunology requests (external site).

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Chronic urticaria >6 weeks unresponsive to standard management (i.e., requiring steroids or not responding to high dose antihistamines)

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, severity, and possible triggers of urticaria Details of previous treatment and outcome/failure to respond to antihistamines Current medication list Any known allergies
Examination	Nil
Investigations	Nil

Highly desirable
History	Nil
Examination	Nil
Investigations	FBC U&E LFT TFT Thyroid peroxidase (TPO) antibodies CRP ESR Helicobacter serology ANA Serum IgE

Indicative clinical urgency category
Category 1 Appointment within 30 days	No defined category 1 criteria
Category 2 Appointment within 90 days	Chronic urticaria requiring steroids or not responding to high dose antihistamines
Category 3 Appointment within 365 days	All other chronic urticaria

Indicative clinical urgency category

Category 1

Appointment within 30 days

Category 2

Appointment within 90 days

Chronic urticaria requiring steroids or not responding to high dose antihistamines

Category 3

Appointment within 365 days

Exclusions
Acute or chronic urticaria which has remitted unless allergic cause suspected. Refer to dermatology: Eczema Persistent rash with uncertain diagnosis Contact dermatitis See Clinician Assist WA: Dermatology Requests (external site)

Useful information
See Clinician Assist WA: Urticaria (external site) For further information, see Health Professionals - Australasian Society of Clinical Immunology and Allergy (ASCIA) (external site)

Useful information

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