Hereditary Haemorrhagic Telangiectasia (HHT), Activin A Receptor Like Type 1 (ACVRL1), Mothers Against Decapentaplegic homolog 4 (SMAD4), Phosphatase and Tensin homolog (PTEN), Ras p21 protein activator 1 (RASA1), PIK3 CA and Ephrin 4 (EPHB4) testing were all negative for pathogenic mutation. This evidence concerns the gene SMAD4 and hereditary hemorrhagic telangiectasia.