Reduced Hepatic Blood Flow and Intestinal Malabsorption in Severe Falciparum Malaria

Malcolm E. Molyneux Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Sornchai Looareesuwan Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Ian S. Menzies Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Stephen L. Grainger Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Rodney E. Phillips Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Yupaporn Wattanagoon Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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Richard P. H. Thompson Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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David A. Warrell Liverpool School of Tropical Medicine; Mahidol University, Bangkok; Rayne Institute, St. Thomas's Hospital, London; and John Radcliffe Hospital, Headington, Oxford

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We have studied intestinal function and liver blood flow in Thai adults with complicated and uncomplicated falciparum malaria. The absorption of 3 orally administered test sugars, D-xylose, 3-0-methyl-D-glucose, and L-rhamnose, was greatly reduced in complicated malaria, while the lactulose/rhamnose absorption ratio was significantly increased. Hepatic blood flow was concomitantly reduced in severe malaria. These deviations reverted to normal in convalescence. Neither sugar absorption nor liver blood flow was reduced in uncomplicated falciparum malaria.

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