“…1 Generally, PAVMs were congenital, most commonly associated with HHT in 80% to 95%. 2,3 HHT or also known as Osler-Weber-Rendu syndrome is an autosomal dominant disease with almost complete penetrance an variable phenotype, linked to the suppression of the inhibition of tranforming growth factor beta (TGF beta) on angiogenesis, by mutation of the ENG or ACVRL 1 genes. 4,5 A number of others conditions, are more rarely associated with acquired PAVMs, such as hepatic cirrhosis, shistosomiasis, mitral stenosis, and metastatic thyroid carcinoma etc.…”