Impact of immunostimulation on autoinflammatory disease. CRMO case presentation and literature review: A case report.

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare bone condition included in the spectrum of autoinflammatory pediatric rheumatological diseases. In the present case report, a 9-year-old female patient with a personal history of psoriasis since the age of 5 presented with left clavicle pain persisting for ~2 months. Following thorough anamnesis and investigations carried out, a diagnosis of CRMO was established. The present case report discusses a rare pediatric autoinflammatory pathology with autoimmune implications, emphasizing the role of immunostimulation/immune dysfunction. It is possible that immunostimulation with Propionibacterium acnes (also known as Cutibacterium acnes) for psoriasis management may underlie the development of autoinflammatory-destructive bone lesions. Establishing causal relationships between immunological, bacterial and autoinflammatory factors was challenging during the patient's evaluation in our service.