findings to date. These findings suggest that FBN1 C-terminal missense mutations may not confer the ophthalmological features of Marfan syndrome, but they also confer a more significant risk for cardiovascular pathology than that suggested by previous studies. Furthermore, clinical data from this family supports the previously reported association of dural ectasia with C-terminal mutations. Copyright © 2013 S. Karger AG, Basel Marfan syndrome is an autosomal dominant connective tissue disorder with an incidence of between 1 and 3 per 10,000 individuals [Gray et al., 1994;Ramirez et al., 2007]. The disease predominantly manifests in the cardiovascular, skeletal and ocular systems as well as in the dura mater. Prominent cardiovascular features include dilatation of the aorta and proximal pulmonary artery as well as prolapse of the mitral and tricuspid valves. Musculoskeletal manifestations include joint laxity, chest deformities and overgrowth of tubular bones. Myopia is common and lens displacement is thought to occur in over 60% of affected individuals throughout their lifetime [Maumenee, 1981;Dietz, 1993;Ammash et al., 2008;Datta Kanjilal and Datta, 2009]. The recently revised Ghent Key Words Cardiovascular phenotype · Diagnostic criteria · FBN1 · Marfan syndrome · Novel mutation Abstract Marfan syndrome is an autosomal dominant connective tissue disorder caused by mutations in the fibrillin gene FBN1 , which encodes an extracellular matrix glycoprotein. Major features of Marfan syndrome occur in the ocular, cardiovascular, and skeletal systems as well as in the dura mater. Approximately 60% of known disease-causing mutations are missense mutations of single amino acid residues. Effects on the cardiovascular system are classically associated with mutations in exons 24-32 of the 65 FBN1 exons and many, though not all, reports associate missense mutations in exons 59-65 with a mild cardiovascular phenotype. Here we present 5 related individuals among whom a c.7409G>A (p.Cys2470Tyr) missense variant in exon 59 of FBN1 is associated with significant cardiovascular features. The index case also had an apparently de novo 46,XX,del(5)(q33.1q33.3) deletion on chromosome 5. This family demonstrates skeletal, dermatological and neurological features consistent with Marfan syndrome but lacks significant ophthalmological