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Aims: Graves' disease is a common cause of hyperthyroidism in the paediatric population. An association between neutropenia and untreated Graves' disease has been described although the aetiology is unknown. Presentation of Case: A 13 year old boy presented with a 3 month history of weight loss, insomnia, fatigue, palpitations and anxiety. On examination, he had tachycardia of 140 beats/minute, sweating, tremors and brisk deep tendon reflexes. The clinical and laboratory results were consistent with Graves' hyperthyroidism. He was treated with Lugol`s iodine and Propanolol in view of his low neutropenia count at diagnosis. Discussion: Thionamide drugs remain the initial treatment of choice in children and adolescents presenting with Graves' disease, however adverse effects such as agranulocytosis remains a concern. Conclusion: In cases where anti-thyroid thionamides are contraindicated due to the risk of side effects such as agranulocytosis or neutropenia, Lugol's iodine may be an alternative temporary form of first line therapy

The Use of Iodine as First Line Therapy in Graves' Disease Complicated with Neutropenia at First Presentation in a Paediatric Patient