1. Although immune related myasthenia gravis (irMG) is a rare complication of immune checkpoint inhibitors, its associated morbidity and mortality is extremely high and knowledge of and identification of this complication is important.

2. Patients with irMG almost always require admission for observation and treatment as their initial symptoms may not reflect how quickly they can proceed to life threatening complications such as respiratory failure.

3. Consider concurrent immune related adverse events in patients presenting with irMG, including myositis, myocarditis, hepatitis, pneumonitis, and peripheral neuropathy.

4. Treatment often requires steroids as well as IVIG and PLEX.

5. In patients that you are worried about myositis, also consider other potential causes, including medications like statins that could be contributing.