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A 40-year-old man with acquired immunodeficiency syndrome (AIDS) presented with severe thrombocytopenia and disseminated Kaposi's sarcoma (KS). Initially diagnosed with immune thrombocytopenic purpura (ITP), he was treated with corticosteroids and antiretroviral therapy; however, his condition worsened. He met the criteria for Kaposi's sarcoma-associated inflammatory cytokine syndrome (KICS) and received liposomal doxorubicin, showing temporary improvement. KS progression was observed after immune recovery, suggesting KS-associated immune reconstitution inflammatory syndrome. Rituximab was administered, but the patient deteriorated and died. This case highlights the difficulty in distinguishing KICS from ITP, and the importance of an early diagnosis and multidisciplinary care in advanced AIDS.