Binding of Isaac 135 - April Fools Pain
All the items can be whatever they want and even if you have the specific item, they do a random effect each time. Drops are whatever they want as well so picking up a bomb will give you a key or maybe a fart. All the bosses are Bloat because suffering is fun.
Credit for The Binding of Isaac: Repentance goes to Nicalis Inc, Edmund McMillen, and their team.
To get The Binding of Isaac: Repentance for yourself go to https://store.steampowered.com/app/1426300/The_Binding_of_Isaac_Repentance/
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