Adrenal disorders

​​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Adrenal crisis (i.e. haemodynamic compromise) associated with vomiting, and/or hyponatraemia, and/or hypoglycaemia resulting in unconsciousness or seizure
  • Phaeochromocytoma in crisis with uncontrolled hypertension
  • Severe and symptomatic (e.g. headaches) hypertension, or high or fluctuating blood pressure with headaches, visual disturbance or other neurological symptoms
  • Suspected or confirmed new diagnosis of acute adrenal insufficiency
  • Suspected pituitary mass (e.g. symptoms of visual field loss or central nervous system signs)
    Note: refer to pituitary disor​ders state-wide referral criteria​

When public outpatient services are not routinely provided

  • Nil

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Adrenal mass
​Category 2
Recommended to be seen wtihin 90 calendar days.
  • ​Any form of suspected adrenal disorder
  • Premature adrenarche (i.e. axillary or pubic hair and/or body odour in females aged < 8 years or males aged < 9 years)
  • Suspected Cushing's syndrome
  • Treated primary or secondary adrenal insufficiency​

Category 3
Recommended to be seen within 365 calendar days.

  • ​Nil

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Examination findings, including Tanner staging and presence of hyperpigmentation
    • Height and weight
    • Blood pressure trends
    • Blood glucose levels (BGL)
    • Electrolytes, Urea, Creatinine (EUC)
    • Serum cortisol and adrenocorticotropic hormone (ACTH) (with specimen collected between 0800-0900)
    • Renin (if primary adrenal insufficiency suspected)
    • 24-hour urinary free cortisol, or midnight salivary cortisol test (if Cushing's syndrome suspected)
    • Luteinising hormone (LH), follicle-stimulating hormone (FSH), oestradiol or testosterone (if signs of early puberty or adrenarche)
    • 17-OH progesterone and androgen profile (if considering congenital adrenal hyperplasia (CAH)

If available

  • ​Adrenal imaging results

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing