We describe an adult male patient with acquired generalized lipodystrophy preceded by autoimmune thrombocytopenia.A 44-year-old man with adult-onset type I diabetes presented with 4 weeks of fat wasting in his face, neck, torso, and arms. He was hospitalized 9 months earlier for epistaxis and isolated thrombocytopenia with a presenting platelet count of 3 k/mL. Autoimmune thrombocytopenia was diagnosed and found to be refractory to twice-daily intravenous methylprednisolone, intravenous immunoglobulin 1 g/kg/d for a total of 6 noncontiguous doses, and rituximab 375 mg/m 2 weekly for 4 doses. Bone marrow biopsy was normal. Hepatosplenomegaly on ultrasound was attributed to hepatic steatosis after ruling out human immunodeficiency virus and viral hepatitis. Intravenous immunoglobulin therapy was complicated by Coombs-positive hemolytic anemia Figure Loss of subcutaneous fat from the (A) face, (B) limbs, (C) neck, and (D) trunk.