Genetic testing, including comparative genomic hybridization microarray to rule out copy number variation, mitochondrial DNA sequencing, and next-generation sequencing of a panel of 29 congenital and acquired lipodystrophy genes (ADRA2A, AGPAT2, AKT2, ATP6V0A2, BANF1, BSCL2, CAV1, CAVIN1, CIDEC, FBN1, IGF1R, KCNJ6, LIPE, LMNA, LMNB2, MFN2, PCYT1A, PIK3R1, PLIN1, POLD1, PPARG, PSMA3, PSMB4, PSMB8, PSMB9, SPRTN, TBC1D4, WRN, ZMPSTE24), including mitofusin-2 (MFN2) associated with multiple lipomatosis, was unrevealing for additional diagnoses beyond MMUT MMA. Here, TBC1D4 is linked to acquired lipodystrophy.