Hypersensitivity to hen egg (HE) is a common cause of food allergy in children. Clinical and serological crossreactivity between hen egg proteins and those of other birds eggs (turkey, duck, goose, sea-gull) have been described (1). Only serological cross-reactivity (2) but not clinical reactions to quail egg (QE) have been reported. Quail eggs are easy to buy in Italy and have been termed as appropriate for children suffering from HE allergy. We report a case of QE anaphylaxis in a child with HE allergy. D.G. is a 5-year-old boy, without a family history of allergic disease, born after a regular first pregnancy. He was breast-fed for 6 months and, after the fifth month, his feed included cow’s milk. At the age of 6 months, he developed atopic dermatitis and was diagnosed to be allergic to both cow’s milk and HE proteins. He was put on a diet without cow’s milk and HE until the age of 12 months. At that time, it was possible to include cow’s milk but not HE as he continued to show strong skin prick test (SPT) reactivity (>10 mm) to HE. From the age of 3 years, he developed allergic rhinitis and asthma episodes, mainly at home, during autumn. SPT and specific IgE showed dust mite sensitization (Table 1). Total IgE levels were 266 kU/ml. He was admitted to our hospital because of angio-edematous rash, rhinoconjunctivitis with edema of tarsal conjunctiva, wheezing and illness. These symptoms had arisen immediately after he had rubbed his face with his hand that had traces of QE and regressed in about 30 min after intramascular antihistaminic treatment and nebulized bronchodilator therapy. The child had never eaten any bird species nor had any pets or birds at home. The QE had been used for cooking, on the advice of the family doctor who did not consider QE dangerous in spite of the child’s HE allergy. Prick–prick tests (PPT) were strongly positive to both crude HE and QE white and yolk. SPT with HE white and yolk (Stallergenes S.A., Fresnes/Paris, France) as well as specific IgE for HE white and yolk (Pharmacia Upjohn AB, Uppsala, Sweden) were also strongly positive, while specific IgE for QE was not available. (Table 1). To evaluate if cutaneous cross-reactivity between HE and QE white and yolk was particular in this child or more common, we performed PPT with crude HE and QE egg white and yolk on 25 atopic children (mean age 47.8 months), 15 of who showed PPT positivity and allergy to HE. All children with PPT positive to egg white (n 1⁄4 15) and yolk (n 1⁄4 13) of HE showed positive PPT to QE also (for both egg white and yolk) and none of the children with negative PPT to HE showed PPT positive to QE (Spearman correlation 1.0; P < 0.0001).The SPT wheal mean diameter was 9.2 and 5.7 mm for HE white and yolk, 6.9 and 5.4 mm for QE white and yolk, respectively. Oral challenges with HE and QE were not carried out because of the lack of informed consent. We describe a child experiencing anaphylaxis at first contact with QE while reporting HE allergy. Furthermore, we show a strong correlation between HE and QE PPT positivity. Severe egg allergy by skin contact has been described (3) and wheezing has been possibly attributed to inhalation of egg proteins (4). As hen and quail belong to the same classification, Galliformes , this suggests the possible presence of crossreactive epitopes among the eggs of the two bird species and thus may explain the wide cross-reactivity, as already described for other bird eggs. In absence of oral challenges, we could not definitely establish clinical cross-reactivity between HE and QE. However, the child’s history, as well as the skin test correlations detected in the atopic group strongly recommend the avoidance of QE in children affected with HE allergy. AL LERGY 2 0 0 5 : 6 0 : 1 2 8 – 1 3 3 • COPYRIGHT a 2005 BLACKWELL MUNKSGAARD • ALL R IGHTS RESERVED • CONTRIBUT IONS TO THIS SECT ION WILL NOT UNDERGO PEER REV IEW, BUT WILL BE REV IEWED BY THE ASSOCIATE EDITORS •