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You will only know for certain until you obtain a copy of his birth certificate and/or baptism certificate, which I don't think should be all that difficult to do for the late 19th century. You could research which Italian archive has these in their possession and then e-mail or write to them with the polite request of sending you a copy. This will of course involve fees, for example: 10 euro per copy plus money for the amount of time it took for archive personnel to find the certificates.

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If the birth certificate and baptism certificate both say that his given name was indeed Pellerino, then it seems likely to me that Pellerino must have been a local (Napolitan) variant of Pellegrino. Also see this (it's about the surname, but also relevant for the first name): https://it.wikipedia.org/wiki/Pellegrini_(cognome)

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But if the certificates actually list Pellegrino instead of Pellerino, then it seems likely to me that your great-great-grandfather intentionally dropped the 'g' from his name in order to make it easier to remember and pronounce for Americans. He wouldn't be the first who did something like that upon immigration to the United States, nor will he be the last. As such, I would take his American records with a pinch of salt.

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So, again, try to get your hands on the records that are left of him in Italy - these will be the key and answer to your question, since they should be the most authentic.

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"It is no measure of health to be well-adjusted to a profoundly sick society." ~ Jiddu Krishnamurti (1895-1986)