What are the indications for referring a patient with Alagille Syndrome to a specialist for further management?

Indications for referring a patient with Alagille syndrome to a specialist for further management include:

• Presence of significant liver disease manifestations such as cholestasis, pruritus, or signs of liver dysfunction requiring specialist hepatology or gastroenterology input.
• Complications related to cardiac abnormalities commonly associated with Alagille syndrome, necessitating cardiology specialist assessment.
• Signs of systemic involvement or multisystem complications, including renal, skeletal, or ocular abnormalities, which require multidisciplinary specialist evaluation.
• Any clinical features suggesting worsening or complex disease that cannot be managed in primary care, including failure to thrive or developmental concerns.
• Need for genetic counselling and family assessment due to the inherited nature of Alagille syndrome.

Referral should be made to a paediatrician or adult specialist with expertise in managing Alagille syndrome, often a paediatric hepatologist, gastroenterologist, or cardiologist, depending on the predominant clinical issues.