Capillary Permeability as Measured by the Amsler-Huber Fluorescein Test in Bleeder Families on the Åland Islands

In a series of 47 subjects aged 6—80 years belonging to bleeder families on the Aland Islands the capillary permeability in the blood-aqueous barrier was studied by the Amsler-Huber fluorescein test and the capillary fragility was simultaneously tested according to the Rumpel-Leede method. In most of the cases investigated, the haemorrhagic diathesis had been thoroughly examined by modern coagulation tests. No consistent correlations were observable between capillary permeability and bleeding time as determined previously or at the time of the present study. Capillary permeability was found to decrease with age, just as does the haemorrhagic tendency itself. Capillary fragility was often, but not invariably, accompanied by capillary permeability. When the probands in the Åland bleeder families exhibited both a history of serious haemorrhages, markedly prolonged bleeding times and pathological capillary fragility, the response to the Amsler-Huber fluorescein test was often, but not invariably, pathological and appeared to be most strongly correlated with capillary fragility (RumpelLeede).

Two subjects, mother and daughter, responded to fluorescein injection by a relatively severe allergic reaction. Nonetheless, markedly increased permeability was not observable in the capillary system of their eyes.

In the Aland bleeder syndrome there are marked fluctuations in the history of bleeding, bleeding time, capillary fragility and certain coagulation tests. Similarly, there seem to be obvious variations, both intra-familial and intraindividual, in capillary permeability as measured by the Amsler-Huber fluorescein test. No definite correlation was observable between increased capillary permeability and pathological platelet function.