Objective  To investigate the diagnosis and treatment characteristics of pure red cell aplasia (PRCA) caused by human parvovirus (HPV) B19 infection after renal transplantation.

  Methods  Two cases with PRCA caused by HPV B19-induced after renal transplantation, who were treated in the Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, were summarized. Combined with literature review, the clinical characteristics, diagnostic method, course of treatment and prognosis of such disease were investigated.

  Results  Two renal transplant recipients developed severe anemia early after transplantation with progressive deterioration and failed transfusion therapy. Other causes of anemia were ruled out and two patients were diagnosed as PRCA caused by HPV B19 infection according to bone marrow aspiration and biopsy as well as HPV DNA detection by fluorescent polymerase chain reaction (PCR). The symptoms of anemia were improved significantly after adjustment of immunosuppressive treatment protocol and intravenous immunoglobulin (IVIG).

  Conclusions  For patients with unexplained and progressed anemia early after renal transplantation, especially those complicated with reticulocyte deficiency, the possibility of PRCA caused by HPV B19 infection shall be considered. The results of bone marrow aspiration and fluorescent PCR are the main bases for diagnosing PRCA. Immunosuppressive agents reduction and application of IVIG are the major treatment measures. Most of patients have great prognosis after treatment, but this disease is likely to recur.