Maureen Zuzevich, recruitment program manager for the Kraft Family Blood Donor Center, was heading home last year from a blood drive she had coordinated at Gillette Stadium when she was overcome by nausea. She quickly pulled over to the side of the road.
It was May 2020 — the first wave of the COVID-19 pandemic was in full swing. Zuzevich’s mind started racing as she sat in her car, overwhelmed by a sudden onset of coughing, vomiting and feeling feverish.
“I called my husband and said, ‘Jim, I’ve been sick. You’d better not come near me when I get home. I think I’ve got COVID,’” Zuzevich recalled.
It was a reasonable assumption — one that her primary care provider agreed with when they spoke by phone later. But when a COVID-19 test came back negative, Zuzevich and her provider didn’t know what to make of the results. It must be an error with the test, they decided.
But it wasn’t a mistake. Zuzevich retested multiple times and got the same result: negative for COVID-19. Imaging suggested she might have pneumonia, but the antibiotics and steroids she was prescribed did nothing to alleviate her illness. On the contrary, her health continued to deteriorate.
“I’ve never called in sick to work in my life, but I felt so terrible that I had to,” she said. “After two weeks of this, I really had not been myself. I just looked at my husband and said, ‘Take me to the Brigham. Something is wrong.’”
That decision, Zuzevich and her family would soon learn, saved her life. And Zuzevich, who has spent the past 25 years recruiting blood and platelet donors, would find herself on the other side of that relationship as she experienced firsthand how vital it was to have a robust blood bank for patients in need — patients like her.
‘I Called Them My Angels’
In the Emergency Department, Zuzevich’s care team discovered what was causing her to feel so sick: She was in severe, acute kidney failure. Zuzevich was stunned.
“Up until then, I never had any major health problems, and there was nothing like this in my family history,” she said. “I remember them telling me that if my husband hadn’t brought me in that Friday, I might’ve died by Sunday.”
Due to shifting bed capacity needs during the peak of the pandemic, Zuzevich was transferred to Brigham and Women’s Faulkner Hospital, where she underwent a kidney biopsy and was started on antibiotics. Her condition, however, continued to worsen, and her care team still didn’t know why.
Meanwhile, a Brigham pathologist was working to unravel the mystery. Helmut Rennke, MD, director of Renal Pathology, successfully identified the root cause of her illness: two extremely rare, life-threatening autoimmune disorders.
One was anti-glomerular basement membrane (anti-GBM) disease, also known as Goodpasture syndrome, which was causing her immune system to mistakenly attack healthy kidney tissue. Only one in 1 million people are diagnosed with it each year. The other disease, ANCA (anti-neutrophil cytoplasmic antibodies) vasculitis, causes white blood cells to attack small blood vessels in the body — damaging blood vessels and causing tissue swelling. It is also rare, affecting an estimated one in 50,000 people each year. Both the anti-GBM and ANCA antibodies are “autoantibodies,” meaning that they are specific for normal human proteins. In Zuzevich’s case, these autoantibodies had caused severe, diffuse inflammation in greater than 90 percent of the renal filters (“glomeruli”) that had been sampled in her kidney biopsy.
The severity of her disease and the advanced care it required prompted Zuzevich’s care team to transfer her back to the Brigham’s main campus. Staff were waiting in the ambulance bay to bring her for an emergency plasma exchange to remove the anti-GBM and ANCA autoantibodies from her bloodstream.
“I was told that they [Transfusion Medicine staff] stayed late. I recognized the faces that were there waiting for me,” Zuzevich said. “It’s emotional even thinking about it. I called them my angels.”
Gratitude for the Gift of Life
Zuzevich remembered watching the dark brown, sludgy plasma leave her body as the transfusion began. Based on her work with the Kraft Center, she knew it meant a grave amount of toxins had built up in her body. Healthy blood plasma is typically yellow.
She would spend the next three weeks hospitalized at the Brigham, undergoing kidney dialysis, treatment with immunosuppressive medications, and a total of 14 plasma exchange treatments. She also benefited enormously from the support of the Brigham “KidneyPal” program, a multidisciplinary Nephrology and Palliative Care team, as she adjusted to the realities of dialysis. As her health and kidney function improved, she was discharged and transitioned to outpatient dialysis, with the occasional need for whole blood transfusions.
Although her kidneys sustained considerable damage — to the point that Zuzevich may eventually require a kidney transplant — their function recovered enough that she was able to discontinue dialysis last fall.
“Quite miraculously, Maureen is getting better, and I’m optimistic she will continue to improve,” said David Mount, MD, associate chief and clinical chief of Renal Medicine and director of Dialysis Services, who led the multidisciplinary team caring for Zuzevich. “Patients with anti-GBM disease with the severity of her renal inflammation and with the degree of her acute renal failure at presentation usually remain dialysis-dependent, with ‘end-stage’ kidney disease. What made the difference here was the aggressive, multi-pronged therapeutic approach, using high-dose prednisone, rituximab, cyclophosphamide and an extended course of plasma exchange.”
He continued, “I think it also speaks to the outstanding collaboration with our Renal and Medicine colleagues at the Faulkner, our wonderful Renal Pathology division, the dedicated team at the Blood Bank and our innovative KidneyPal program. Everybody pulled together to make a rapid diagnosis, give her the highest possible chance of recovery and support her during this difficult period.”
Reflecting on the care she received, Zuzevich struggled to find words to express her gratitude to her care team.
“The Brigham and Dr. Mount saved my life. I think if I went anywhere else, I wouldn’t be here today,” she said. “Really, every single person who cared for me was amazing. The love and compassion they gave me — it’s overwhelming. I can’t thank them enough.”
And as blood banks around the country, including the Brigham’s, face continued shortages, Zuzevich said she is especially touched by the anonymous whole blood and plasma donors for their gift of life.
“It just hit home for me — right at my heart. I’m so grateful to our donors, even more than I was before,” she said. “I remember when I was receiving a blood transfusion, I looked up at the bag and took a picture of it with my phone. I sent it to my friends at the Blood Donor Center and said, ‘Keep on collecting, girls.’”
All blood products donated at the Kraft Center directly benefit patients at the Brigham and Dana-Farber Cancer Institute. To donate whole blood or plasma at the Kraft Center (open seven days a week), schedule an appointment online, email BloodDonor@partners.org or call 617-632-3206. Walk-ins are also welcome. View a calendar of upcoming blood drives open to the community.