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Fire brigades said the stampede took place in the Lanterna Azzurra nightclub in the town of Corinaldo, near Ancona, on the Adriatic coast.
One of dead was a mother of a teenager. About 50 other people were injured, about a dozen seriously.
The cause of the stampede was not immediately clear but first reports on Italian media said the teenagers were trying to escape from the nightclub after someone had set off a can of pepper spray.