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Vasculitis Non GCA Temporal Arteritis Referral Access Criteria

Vasculitis Non GCA Temporal Arteritis Referral Access Criteria

Referrers should use this page when referring patients to public adult rheumatology outpatient services for Vasculitis (non-Giant Cell Arteritis/Temporal Arteritis).
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.
  • Complications of disease or therapy requiring emergency review – systemically unwell
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate rheumatology assessment (seen within 7 days):
  • Acute, otherwise unexplained, monoarthritis
  • Acute, otherwise unexplained, polyarthritis
  • Patients with a previously diagnosed condition who are acutely unwell e.g.:
    • Chronic idiopathic arthritis (inflammatory arthritis, psoriatic arthritis, axial spondylitis)
    • System lupus erythematosus, myopathies, scleroderma
    • Necrotising vasculitis (anti-neutrophilic cytoplasmic autoantibody-associated vasculitis)
    • Patients on biological agents

To contact the relevant service, see HealthPathways: Acute Rheumatology assessment (external site).
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Fatigue
  • Fever
  • Muscle or joint pain
  • Poor appetite
  • Weight loss
  • Numbness or weakness in various parts of the body

Other symptoms might develop, depending on the type of vasculitis.

  • Skin: rash, sores or purple or red spots, urticaria, itching
  • Joints: aches and pains, arthritis
  • Lungs: dyspnoea, pneumonia, haemoptysis
  • Eyes: blurred vision, photophobia, redness, itch and burning
  • Digestive tract: mouth ulcers, abdominal pain
  • Sinuses, nose, throat and ears: stuffy or bloody nose, recurrent ear infections, nasal ulcers, hearing loss
  • Brain: headache, changes in cognitive function, muscle weakness, paralysis
  • Nerves: numbness, tingling, weakness, shooting pains
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 due to financial reasons or geographical location).

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 of symptoms including:
    • Whether skin, joint, respiratory, sinus or other
    • Whether presence of swelling/tenderness/synovitis
  • Current medication list
  • Any known allergies
  • Details of previous treatment and outcome
Examination
  • Nil
Investigations
  • FBC
  • U&Es
  • LFTs
  • ESR
  • CRP
  • ANCAs
  • Urinalysis for MCS, casts, protein
Highly desirable
History
  • Nil
Examination
  • Nil
Investigations
  • Skin, artery, respiratory tract, or renal biopsy histology
  • Rheumatic Factor or anti-CCP
  • ANA
  • ENA
  • dsDNA
  • C3, C4
  • CXR
  • Cancer screening information if applicable
Indicative triage category

Category 1

Appointment within 30 days

  • New onset and/or active small, medium or large vessel vasculitis including ANCA associated vasculitis and immune complex vasculitis

Category 2

Appointment within 90 days

  • Vasculitis on established treatment and stable

Category 3

Appointment within 365 days

  • No defined category 3 criteria
Exclusions
  • Nil
Useful information
  • Nil
Last reviewed: 18-03-2024
wa.gov.au