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Case report
Generalised urticaria following ingestion of a nickel-plated coin in a 4-year-old girl
  1. Isabelle Duchesnay1,
  2. Michael H Livingston2,
  3. Lisa VanHouwelingen3 and
  4. J Mark Walton3
  1. 1Division of General Surgery, McMaster University, Hamilton, Ontario, Canada
  2. 2Division of Pediatric Surgery, University of Rochester Medical Center, Rochester, New York, USA
  3. 3Division of Pediatric Surgery, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Michael H Livingston; michael_livingston{at}


We report the case of a 4-year-old girl who presented to the emergency department after ingestion of a nickel-plated coin. Abdominal radiographs confirmed the presence of a coin in her stomach but she was otherwise asymptomatic. She was discharged with assurances that the foreign body would pass spontaneously. The patient developed significant generalised urticaria the next day, which became progressively more severe. Her symptoms prompted endoscopic removal of the nickel-plated coin and a postoperative course of corticosteroids and antihistamine therapy. This is the first reported case of generalised urticaria secondary to ingestion of a coin with nickel plating only (2% nickel content overall). A review of similar cases is provided.

  • dermatology
  • paediatrics (drugs and medicines)
  • endoscopy
  • immunology
  • paediatric surgery

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  • Contributors ID is primarily responsible for design of work, first draft and revision. MHL assisted with design of work, writing subsequent drafts and reviewing final version. MW and LVH assisted with design of work, feedback regarding clinical details and management and reviewing the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.