Immunology admission criteria

This is a list of patient diagnoses which are admitted to Great Ormond Street Hospital (GOSH) by our Immunology team, the timeframe in which they should be treated and their estimated length of stay (LoS). Health professionals are reminded that this information is for guidance only.

Children with the following diagnoses should be transferred to GOSH within days from receipt of referral.

• New Severe Combined Immunodeficiency (SCID)/Di George syndrome
• New confirmed or suspected familial hemophagocytic lymphohistiocytosis
• Immunological assessment of acutely unwell new patient with possible primary immunodeficiency (not SCID)
• Known primary immune deficiency (PID) (any diagnosis) developing significant infection (not CVL) or possible infection that cannot be managed in the local hospital or requires initial diagnostics here (eg biopsy)
• Known PID (any diagnosis) developing complications that cannot be managed in local hospital (eg Wiskott-Aldrich Syndrome (WAS) with active bleeding, Chronic Granulomatous Disorder (CGD) with severe colitis)
• Central venous line (CVL) infection in child with any PID that is not responding to first line treatment or cannot be managed in local hospital
• Post bone marrow transplant (BMT) for PID: CVL infection that is not responding to first line treatment or cannot be managed in local hospital
• Post BMT: significant BMT complications that are severe, not responding to first line treatment or cannot be managed in local hospital

Children with the following diagnoses should be referred to GOSH via the non-emergency pathway.

• Assessment for thymic transplant
• Commencement of non-emergency new treatment eg subcutaneous immunoglobulin (SCIg)
• Elective investigations: multiple booked complex procedures
• Immunological assessment of stable new patient (not SCID)

Reviewed and updated by: Anne Emmett, QM Dec 2023