Evidence that a toxemia-related organism (Hydatoxi lualba) is an artifact.

Preeclampsia-eclampsia and trophoblastic disease have been associated with a wormlike organism, Hydatoxi lualba, recently discovered in smears from circulating blood, trophoblastic tumor tissue, and placental tissue of toxemic patients. To investigate these findings peripheral blood smears from patients with preeclampsia-eclampsia, patients with hydatidiform mole, normal pregnant patients, and nonpregnant subjects were studied. The smears were stained with toluidine blue-O and Giemsa. The average size of wormlike forms found was 2.5 by 0.23 mm. None stained with Giemsa. The frequency of positivity for toxemic patients was 56.5% and 81.8% for normal pregnant patients. Samples from molar pregnancies were negative. Observations performed directly in fresh blood were also negative. The forms were observed not only in peripheral blood but also in serum obtained after centrifugation or passage through Millipore filters. No evidence of reproductive elements was found, and electron microscopy revealed no particular structure. The results suggest that the organism is an artifact.

Experimental induction of a toxemia-like syndrome in the pregnant beagle.

A toxemia-like syndrome was induced in pregnant beagles by intraperitoneal inoculation of concentrates prepared from placentas of patients with preeclampsia-eclampsia and hydatidiform mole, which contained an agent, Hydatoxi lualba, that stained in a unique fashion with toluidine blue-O-. The pregnant dogs inoculated with either of these concentrates progressively developed hypertension, eyeground changes consistent with hypertensive retinopathy, proteinuria, disseminated intravascular coagulation, and hepatic dysfunction in addition to intrauterine growth retardation and intrauterine fetal death. Hepatic periportal hemorrhage and glomeruloendotheliosis, lesions usually seen in preeclampsia-eclampsia, were also noted to occur in pregnant beagles inoculated with these concentrates. A significant increased sensitivity to angiotensin II infusion was also noted. The toxemia-like syndrome did not develop in pregnant beagles when inoculated in a similar fashion with concentrates prepared from placentas from normal term pregnancies which were free of Hydatoxi lualba or in nonpregnant beagles inoculated with concentrates containing Hydatoxi lualba. Although the agent was not injected in pure form, the inoculation of concentrates containing Hydatoxi lualba appears to be required for the manifestation of the toxemia-like syndrome.