Abstract
Background: Anemia is the most common hematological disorder in the world, due to deficiency of micronutrients such as iron, Zn, Se, Cu, folic acid, and vitamins. Iron deficiency impairs immune response and bactericidal activity of macrophages, monocytes, and neutrophils that alters the length and quality of life. Leukocyte count may be altered due to hypoxia and ischemia, which is seen in anemia. A strong association between leukocyte counts and ischemia is seen from the experimental and clinical studies.

Aims and Objectives: The present study was aimed to estimate total leukocyte count (TLC) and differential leukocyte count (DLC), neutrophil-to-lymphocyte ratio (N/L ratio), and platelet count in anemia. N/L ratio has emerged as a useful index in ischemic heart disease (IHD).

Materials and Methods: A total of 30 patients of nutritional anemia in both the sexes were taken as study group, whose hemoglobin level was <6 g%, and they were compared with 30 healthy subjects of same age group. The parameters studied were TLC, DLC, N/L ratio, and platelet count.

Results: TLC is insignificantly higher in anemic subjects. DLC shows, significant rise in absolute neutrophil count (P < 0.005), fall in absolute lymphocyte count significantly (P < 0.005), and rise in eosinophil and basophil count which is not statistically significant. There is not much difference in monocyte count in both groups. Associated poikilocytosis and anisocytosis of red blood cells are present in anemic subjects. N/L ratio is significantly higher in anemics (P < 0.001). Platelet count is decreased significantly in patients of anemia than control subjects (P < 0.001).

Conclusions: Thus, our study highlights that, immunity especially cellular immunity, is influenced by nutritional anemia. High N/L ratio in anemia is associated with IHD and severe anemia is also associated with thrombocytopenia.