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"Ouch-Ouch" Disease: The Osteomalacia of Cadmium Nephropathy

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Department of Medicine, University of Queensland at the Princess Alexandra Hospital, Brisbane, Australia

Ann Intern Med. 1970;73(5):854-855. doi:10.7326/0003-4819-73-5-854
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A concentration of patients with a particular syndrome in one geographical location sometimes provides the necessary pointer to a single disease entity and ultimately the clue to the appreciation of a new etiological or pathological process. Itai-Itai ByŌ, the literal translation of which is "ouch-ouch" disease, is derived from the typical cry of patients with extreme bone pain due to osteomalacia, who are commonly seen in Toyama city on Japan's Inland Sea. Such patients might not be remarkable when seen individually, but the realization that a large proportion of them came from one limited area of the Fuchu-machi plain just


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