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Endocrinology Referral Criteria
Endocrinology Referral Criteria
Patient age
Under 17 years of age.
Patient acceptance
- Endocrine condition or concern that we provide consults for.
- Transfer of care.
- Specific endocrine question to be answered
- All required supporting clinical documentation provided.
- Complete referral is a must.
Clinical criteria
Atypical or ambiguous genitalia:
- Bifid scrotum, severe hypospadias, particularly if one or both gonads are undescended
- Fused labia/posterior labia fusion, urogenital sinus
- Micropenis
- Clitoromegaly
- Difference between genetic sex and external or internal genitalia
- Mosaic or complex sex chromosome abnormality with atypia of external genitalia
- Congenital adrenal hyperplasia
- Androgen insensitivity syndrome
- Gonadal dysgenesis
- Ovotesticular DSD
- Disorders of testosterone synthesis
- 5-alpha reductase deficiency
Conditions to be referred to other Clinics
- Turner Syndrome: Endocrinology
- Klinefelter Syndrome: Endocrinology
- Mullerian anomalies, vaginal or uterine agenesis: Gynecology
- Isolated hypospadias: Urology
Rejection criteria
- No sign or symptoms of endocrine condition/concern.
- Over 17 years of age.
- General surveillance for a child at risk for a future endocrine condition (May provide an initial consult for some diagnoses but then PCP to follow and re-refer if or when condition develops).
- If borderline endocrine lab results will request repeat labs.
- Inadequate referral documentation for triage.
- Medical tourism.
Required supporting documentation
- Growth charts with serial measurements.
- Relevant endocrine labs and imaging reports (Bone age X-ray or MRI or ultrasounds).
- Karyotype tests.
- Clinical notes, relevant consult notes and any notes from a first opinion (If this referral is for a second opinion).
- Families to obtain out of province/country relevant medical notes and information to be included with referral before referral made for new to province patients.
Community clinical resources
Community-based Paediatric Endocrinologist or Paediatric Endocrine Centre (Hamilton, London, Kingston, Ottawa).