Factors Associated With Elevated C‐Reactive Protein Levels in Women With Systemic Lupus Erythematosus Followed at the Cocody University Hospital, Abidjan, Côte d’Ivoire

Systemic lupus erythematosus (SLE) is a chronic autoimmune connective tissue disease characterised by multivisceral involvement and the presence of autoantibodies. In this context, C‐reactive protein (CRP) holds a particular position: a moderate rise accompanies autoimmune flares, whereas a sharp elevation suggests an infection or specific inflammatory manifestations. This study aimed to analyse the factors associated with increased CRP levels in women with lupus followed at the Cocody University Hospital in Abidjan. This was a cross‐sectional observational study including 62 adult women with SLE (ACR/EULAR criteria). Collected variables included socio‐demographic, clinical, biological and immunological data. CRP was categorised into three groups: (<6 mg/L, 6–20 mg/L and >20 mg/L). Univariate and multivariate analyses were performed using binary logistic regression, supplemented by the estimation of marginal effects. The results show a mean CRP concentration of 28.2 ± 21.2 mg/L. A CRP level >20 mg/L was common and significantly associated with renal manifestations, arthralgia/arthritis and the severity level of pain. Biologically, proteinuria ≥0.5 g/24 h, hypercreatininemia and leukocytosis were strongly correlated with elevated CRP. In multivariate regression, only hypercreatininemia remained significant (odds ratio [OR] = 24.8; p = 0.011). The estimation of marginal effects confirmed its major impact (+47.5 probability points), as well as that of proteinuria (+31.3 points) and obesity (+14.1 points), while overweight appeared protective (−19.2 points). The SLE Disease Activity Index (SLEDAI) score was positively but modestly correlated with CRP (+1.4 probability points/unit). The model’s ROC curve showed excellent performance (area under the ROC curve [AUC] = 0.84). In conclusion, elevated CRP levels were primarily associated with renal manifestations, notably proteinuria and elevated serum creatinine, as well as with disease activity. CRP could therefore serve as a complementary biomarker in the assessment of patients with SLE, particularly in the presence of renal involvement. However, these results should be interpreted as associations and require confirmation by longitudinal studies.