CASR and hypoparathyroidism: Most notable are l-asparaginase, which is used in the treatment of leukemia,(100) and nivolumab, an anti-PD-1 immune checkpoint inhibitor that has been associated with development of activating autoantibodies against the CaSR.(101) In addition, fetal exposure to retinoids, alcohol, or hyperglycemia via poorly controlled gestational diabetes are associated with a DiGeorge-like syndrome and parathyroid dysgenesis without an obvious genetic deletion, although clinical hypoparathyroidism is uncommon.(102)