A 52-year-old man was admitted to our hospital because of exacerbation of the symptoms, such as limp and tremor. HTLV-1 associated myelopathy (HAM) , which it was six years since he was diagnosed. Then he started to take Predonisolone (PSL) 30-60 mg/day. After treatment by PSL, symptoms of HAM were gradually improving. But from 50th hospital day, epigastralgia, nausea and vomitting were appeared, following by bloody stool. An X-ray film of the abdomen showed the small bowel gas with the fluid level. Endoscopic examination revealed diffuse redness, erosion and swelling in the duodenal second portion and bulb, and circumferential redness and swelling of esophageal mucosa from pharyngoesophageal junction to esophagogastric mucosal junction (EG junction) , and with two or three linar erosion near EG junction. The biopsy specimen from the duodenum showed larvae of Strongyloides stercoralis, but not the esophagus. This case was thought that severe Strongyloidiasis with esophageal lesion was developed while giving steroid therapy for HAM.
