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Background  We and others have previously reported that familial cytogenetic studies in apparently  de novo  genomic imbalances may reveal complex or uncommon inheritance mechanisms.    Methods  A familial, combined genomic and cytogenetic approach was systematically applied to the parents of all patients with unbalanced genome copy number changes.    Results  Discordant array-CGH and FISH results in the mother of a child with a prenatally detected 16p13.11 interstitial microduplication disclosed a balanced uncommon rearrangement in this chromosomal region. Further dosage and haplotype familial studies revealed that both the maternal grandfather and uncle had also the same 16p duplication as the proband. Genomic compensation observed in the mother probably occurred as a consequence of interchromosomal postzygotic nonallelic homologous recombination.    Conclusions  We emphasize that such a dualistic strategy is essential for the full characterization of genomic rearrangements as well as for appropriate genetic counseling.

Familial imbalance in 16p13.11 leads to a dosage compensation rearrangement in an unaffected carrier