11p15.4 microduplication syndrome is a genetic condition caused by an extra copy of a small region on chromosome 11. Features can include developmental delay, learning differences, and speech or motor delays, and some people have no obvious issues. Signs often begin in infancy or early childhood and tend to be lifelong, but not everyone will have the same experience. Treatment focuses on supportive therapies like speech, occupational, and physical therapy, and on tailored educational support. The outlook varies and many people with 11p15.4 microduplication syndrome do well with early evaluation and ongoing care.
Overview
11p15.4 microduplication syndromeSymptoms
Features of 11p15.4 microduplication syndrome vary widely; some people have few or no problems. Early signs can include developmental and speech delays, low muscle tone, feeding difficulties, subtle facial differences, and, less often, seizures or congenital anomalies.
Outlook and prognosis
Many living with 11p15.4 microduplication syndrome do well with tailored support, especially when therapies start early. Development can be slower, and some have learning or speech needs, but progress over time is common. Ongoing check-ins guide care as needs change.
Causes and risk factors
11p15.4 microduplication syndrome is caused by extra DNA on chromosome 11p15.4. It usually occurs as a new change, but can be inherited; the key risk is having a parent who carries the duplication. No proven environmental or lifestyle causes.
Genetic influences
Genetics is central to 11p15.4 microduplication syndrome, which results from an extra copy of DNA in a specific region on chromosome 11. The exact duplicated genes and size influence symptoms and severity. Most cases are spontaneous, though inheritance can occur.
Diagnosis
Doctors suspect 11p15.4 microduplication syndrome when clinical features and family history suggest a chromosomal change. Diagnosis is confirmed by genetic tests, typically chromosomal microarray. Imaging findings may guide assessment; many ask about the genetic diagnosis of 11p15.4 microduplication syndrome.
Treatment and drugs
Treatment for 11p15.4 microduplication syndrome is tailored to each person’s needs, often guided by which body systems are affected. Care may include developmental therapies, educational supports, and monitoring of growth, learning, and behavior, with specialists involved as needed. Regular follow‑up helps adjust supports over time.
Symptoms
Many families first notice developmental differences in infancy or early childhood—things like slower motor milestones, delayed speech, or feeding challenges. Features vary from person to person and can change over time. 11p15.4 microduplication syndrome can affect growth, learning, muscle tone, and sometimes the shape or function of organs such as the heart or kidneys. Early features of 11p15.4 microduplication syndrome may be subtle, so keeping track of progress over time can be helpful.
Milestones like rolling, sitting, or walking may come later with 11p15.4 microduplication syndrome. Early on, this might look like needing extra time to master new motor skills. With early intervention, many children continue to make steady gains.
First words and combining words may be delayed in 11p15.4 microduplication syndrome. Many understand more than they can say and benefit from speech therapy or alternative ways to communicate.
Processing speed, memory, or attention can differ from peers. Extra time, visual supports, and specialized teaching often help children show what they know.
In medical terms, this is hypotonia; in everyday life, it shows up as feeling floppy in infancy and tiring sooner with activity. It can affect posture, chewing, and fine motor skills.
How people usually first notice 11p15.4 microduplication syndrome?
Many families first notice something around infancy or early childhood, such as feeding difficulties, slower-than-expected growth, or delays in sitting, crawling, or talking. Doctors may pick up features like low muscle tone, subtle facial differences, or congenital issues (for example, heart or kidney findings) during newborn exams or early check-ups, which can prompt genetic testing and reveal the 11p15.4 microduplication. In some cases, the first signs of 11p15.4 microduplication syndrome are found through prenatal ultrasound or genetic screening when measurements or anatomy look different from typical.
Types of 11p15.4 microduplication syndrome
11p15.4 microduplication syndrome is a genetic condition caused by an extra copy of a small segment on the short arm of chromosome 11. Variants depend on the exact size of the duplicated segment and which genes are included, which can shift the mix and intensity of features. People may notice different sets of symptoms depending on their situation. When reading about types of 11p15.4 microduplication syndrome, clinicians often describe them by the genes involved and whether the duplication is inherited or new (de novo).
Small CNV only
The duplication is very small, often involving a single gene or a few genes within 11p15.4. Features may be mild, with subtle learning or speech differences and normal growth. Some individuals may be identified only after a child or relative is diagnosed.
Moderate CNV size
A medium-length duplication includes more genes across 11p15.4. This can bring clearer developmental delays, speech and language challenges, and mild differences in muscle tone or coordination. Growth is often typical, though head size or facial features may vary slightly.
Large CNV extending
The duplicated region spans 11p15.4 and borders adjacent bands. People can have broader developmental delays, feeding or tone difficulties in infancy, and more noticeable learning and behavioral differences. Doctors may also note congenital features on exam.
Gene-specific hotspot
The duplicated segment prominently includes a known dosage-sensitive gene within 11p15.4. Symptoms often align with that gene’s role—such as language delay if neural-development genes are duplicated. Even within the same type, intensity can range from mild to severe.
De novo duplication
The change arose for the first time in the individual and is not inherited from a parent. Features may be more apparent when compared with family members who do not share the duplication. Recurrence risk for future children is usually low but depends on parental testing.
Inherited duplication
The duplication is passed from a parent who may have mild or no noticeable features. Children can show a similar or sometimes different mix of developmental and behavioral findings. Genetic counseling helps clarify family patterns and the types of 11p15.4 microduplication syndrome in relatives.
What genetics can tell you about symptoms
Extra copies of genes on chromosome 11p15.4 can cause small size at birth, delayed growth, feeding challenges, low muscle tone, and developmental or speech delays. Some also have distinctive facial features, congenital heart differences, or learning difficulties, depending on which genes and tissues are affected.
Causes and risk factors
11p15.4 microduplication syndrome is caused by a tiny extra piece of chromosome 11 in the p15.4 region. Most cases happen as a new change by chance in the egg, sperm, or early embryo, and some are inherited from a parent. Family history is a key risk factor for 11p15.4 microduplication syndrome, especially if a parent carries the same duplication or a balanced chromosome change in this region. Environment and lifestyle do not cause the duplication, but they can influence growth, learning, and other features over time. Not everyone with the same risk develops the condition.
Environmental and biological risk factors
Risk for having a baby with 11p15.4 microduplication syndrome mostly stems from chance biological events around conception. Doctors often group risks into internal (biological) and external (environmental). Environmental risk factors for 11p15.4 microduplication syndrome are not well defined, but certain high-dose exposures that harm reproductive cells may raise the chance. Below are the main environmental and biological elements researchers consider today.
Random missteps while eggs or sperm are forming can create extra copies in certain DNA regions. This chance event can result in 11p15.4 microduplication syndrome. It can occur in any pregnancy.
Parts of chromosome 11 contain repeated segments that can misalign during recombination. These natural hotspots make copy-number changes like an 11p15.4 microduplication more likely to happen by chance. They do not reflect anything the parents did or did not do.
As sperm-producing cells age, new DNA changes arise more often. This may slightly increase the chance of a new chromosomal copy change. Any added risk is generally small at the individual level.
Ionizing radiation to the ovaries or testes before conception can damage DNA in reproductive cells. At sufficiently high doses, this could raise the chance of a chromosomal copy gain. Medical imaging typically uses much lower doses than radiation therapy or industrial accidents.
Genetic risk factors
Risk comes from an extra copy of a small segment on the short arm of chromosome 11 that alters the balance of genes in that region. This pattern, known as 11p15.4 microduplication syndrome, can be inherited from a parent or arise for the first time in a child. People with the same risk factor can have very different experiences. Genetic testing is often pursued when early symptoms of 11p15.4 microduplication syndrome prompt questions about development.
Extra gene copies: A small duplication at 11p15.4 adds extra copies of genes in that segment. This change can disturb typical growth and development. Effects depend on which genes are included.
De novo duplication: In many children, the 11p15.4 duplication arises spontaneously in the egg or sperm. Parents do not carry the change and could not have predicted it. The chance of this happening again is usually low unless a parent has hidden mosaicism.
Inherited duplication: The duplication can be passed from a parent who carries the same extra segment. The parent may have mild or unrecognized features due to variable expressivity. Each pregnancy has up to a 50% chance of inheriting the duplication.
Balanced rearrangement: Sometimes a parent has a balanced chromosome rearrangement involving this region, leaving all genes present but rearranged. This can produce an unbalanced 11p15.4 duplication in a child. Chromosome studies in parents help clarify this risk.
Parental mosaicism: Occasionally, a parent carries the duplication in only some cells (mosaicism) and may test negative on a standard blood test. This hidden mosaicism can raise the chance of having another child with the duplication. More sensitive testing may be discussed in these families.
Duplication size matters: The size of the 11p15.4 duplication and the specific genes captured within it vary between families. Larger or gene-rich duplications may be linked to more noticeable features. Lab reports list the start and end points to guide counseling.
Reduced penetrance: Not everyone with an 11p15.4 duplication will show clear health issues. This reduced penetrance explains why some parents carry the change yet feel well. Outcomes can be hard to predict before birth.
Variable expressivity: Even within the same family, the duplication can lead to different combinations and degrees of features. Age, sex, and which genes are duplicated all play a role. Expectations are best tailored to the individual.
Lifestyle risk factors
11p15.4 microduplication syndrome is genetic; lifestyle habits do not cause it, but daily routines can shape symptoms, function, and comfort. Thoughtful choices around movement, nutrition, sleep, and communication can support development and reduce secondary complications. This overview focuses on how lifestyle affects 11p15.4 microduplication syndrome and highlights practical ways families can help. In this context, “lifestyle risk factors for 11p15.4 microduplication syndrome” means habits that may worsen or ease day-to-day challenges linked to the condition.
Regular low-impact play and therapy-informed exercises can strengthen muscles and balance in people with hypotonia. Better motor stability reduces fatigue and supports participation in school and self-care.
Small, frequent, nutrient-dense meals and upright positioning can ease reflux or swallowing challenges sometimes seen with this syndrome. Adequate calories and protein support growth and tolerance of therapies.
Sufficient fluids and fiber help prevent constipation that can follow low muscle tone and limited mobility. Comfortable digestion can improve appetite, sleep, and behavior.
Consistent bedtimes and a calming wind-down can improve sleep quality. Better sleep supports learning, attention, and may reduce seizure risk where seizures are part of the picture.
Risk prevention
Because 11p15.4 microduplication syndrome is present from birth, you can’t fully prevent it, but you can lower the chance of complications and support healthy development. Prevention can mean both medical steps, like vaccines, and lifestyle steps, like exercise. Planning before pregnancy and early, coordinated care after birth make the biggest difference. Spotting early symptoms of 11p15.4 microduplication syndrome and acting quickly can help children reach their potential.
Meet with a genetic counselor to review family history and discuss recurrence risk. They can explain options that may lower the chance in a future pregnancy.
If you are pregnant or planning, talk about tests such as chorionic villus sampling or amniocentesis. Some families consider IVF with embryo testing to reduce the chance of passing on the duplication.
Share the diagnosis or risk with your birth team so early checks are done. This can include hearing, heart, and feeding assessments in the first days of life.
Schedule frequent milestones reviews with your pediatrician. Early signs of delays can be addressed quickly with therapy to prevent secondary problems.
Transmission
11p15.4 microduplication syndrome is not contagious; it can’t be caught or spread between people. It happens when someone has an extra copy of a small segment on chromosome 11; this may arise as a new change at conception or be passed down from a parent who also carries the duplication.
When inherited, the genetic transmission of 11p15.4 microduplication syndrome usually follows an autosomal dominant pattern, meaning each child of a carrier has up to a 50% chance of inheriting the duplicated segment, though features can vary widely. Because some parents have few or no symptoms, testing both parents can clarify how 11p15.4 microduplication syndrome is inherited in a family and refine recurrence risks. A genetic counselor can discuss family planning options and testing for relatives.
When to test your genes
Consider genetic testing if you or your child has growth differences, developmental delay, congenital anomalies, or a family history suggestive of 11p15.4 microduplication syndrome. Testing is also reasonable before pregnancy or during fertility planning to clarify reproductive risks and options. If already diagnosed, targeted testing helps tailor surveillance for growth, cardiac, endocrine, and neurodevelopmental needs.
Diagnosis
Diagnosis of 11p15.4 microduplication syndrome usually starts with noticing patterns in growth, development, or physical features and then confirming them with genetic tests. Because this is a chromosome change present from birth, doctors look for consistent clinical features and use lab testing to verify the exact duplicated region. Genetic testing may be offered to clarify risk or guide treatment. When the genetic diagnosis of 11p15.4 microduplication syndrome is confirmed, it can also help direct care plans and family counseling.
Doctors look for patterns in growth, facial features, and developmental progress that suggest a small chromosomal duplication. A detailed review of pregnancy, birth, and early milestones helps narrow down the possibilities.
A detailed family and health history can help identify whether similar features or learning differences appear in relatives. This context can guide which genetic tests will be most informative.
This is the first-line genetic test to detect small duplications, including those at 11p15.4. It maps the duplicated segment and reports its size and genes involved.
Follow-up tests such as FISH, MLPA, or qPCR can confirm the duplication and check whether all cells carry it. These methods help clarify test results if the initial finding is borderline or mosaic.
Stages of 11p15.4 microduplication syndrome
11p15.4 microduplication syndrome does not have defined progression stages. Features vary widely and tend to reflect how the extra genetic material affects growth, learning, and health, so changes over time are individual rather than following set stages. Different tests may be suggested to help confirm the diagnosis, usually genetic testing such as a chromosomal microarray after a clinical exam and review of family history. Doctors monitor development, speech, and behavior over time—especially any early symptoms of 11p15.4 microduplication syndrome—and may add hearing, vision, heart, or other checks based on needs.
Outlook and prognosis
Many people ask, “What does this mean for my future?”, and the short answer is that the outlook for 11p15.4 microduplication syndrome varies quite a bit from person to person. Some children have mild learning differences and grow into fairly independent adults, while others need ongoing therapies for speech, motor skills, or attention. Growth can be average, small, or occasionally larger than peers, and some families notice feeding challenges or low muscle tone in infancy that improve with time. Doctors call this the prognosis—a medical word for likely outcomes.
When thinking about the future, it helps to focus on what’s showing up now and how it responds to support. Early care can make a real difference, including speech, occupational, and physical therapy, educational plans, and regular hearing and vision checks. If present, heart, kidney, or endocrine findings are usually monitored and treated using standard guidelines, and many people with 11p15.4 microduplication syndrome do well with this routine care. Severe, life‑threatening complications are uncommon in the published reports, and overall life expectancy appears close to typical when major organ problems are not present.
Everyone’s journey looks a little different. Some children meet milestones a bit later and then catch up; others continue to need extra help in school. Families often ask about early symptoms of 11p15.4 microduplication syndrome that might predict the future, but there isn’t a single sign that determines long‑term abilities. In medical terms, the long-term outlook is often shaped by both genetics and lifestyle, including access to therapies, educational supports, sleep, and nutrition. Talk with your doctor about what your personal outlook might look like, and ask how often to check in so plans can be adjusted as your child grows.
Long-term effects
11p15.4 microduplication syndrome is a rare, inherited or de novo chromosomal change, and long-term effects depend on the exact size and genes included in the duplicated segment. Long-term effects vary widely, and some people have few ongoing challenges while others need added supports in school or daily life. Many grow and learn steadily over time, even if milestones came later in childhood. Understanding long-term patterns can guide treatment choices.
Many have mild-to-moderate learning differences that persist into adolescence and adulthood. School and job skills often improve over time, though progress may be uneven.
Ongoing speech or language delays can affect clarity, vocabulary, or social communication. With age, everyday conversation may become easier, but expressive language can remain a relative challenge.
Some people have shorter stature or smaller head size compared with peers, while others track within typical ranges. Growth differences in 11p15.4 microduplication syndrome tend to be stable rather than rapidly changing.
Low muscle tone or coordination differences in childhood can lead to persistent clumsiness or fatigue with fine tasks. Many improve motor control over time, but subtle challenges may remain.
How is it to live with 11p15.4 microduplication syndrome?
Living with 11p15.4 microduplication syndrome can mean a mix of developmental differences—such as speech and motor delays, learning differences, and sometimes distinctive facial or growth features—alongside many personal strengths. Day to day, families often juggle therapies, school supports, and medical check-ins, which can be tiring but also bring steady progress when services are coordinated and consistent. People around you—siblings, classmates, caregivers—may need simple, clear explanations and patience as communication and routines are built, and most find that structured schedules, visual supports, and celebrating small gains make life smoother. Many families report that advocacy skills grow quickly, and with early intervention, tailored education plans, and healthcare follow-up, children and adults with this duplication can thrive in their own way.
Treatment and drugs
Treatment for 11p15.4 microduplication syndrome focuses on the specific symptoms and needs of each person rather than a single set plan. You might picture this as a team effort between you and your doctor, often including a pediatrician, geneticist, therapist, and sometimes a cardiologist, eye specialist, or neurologist, depending on features present. Early interventions can include physical, occupational, and speech therapy to support movement, coordination, feeding, and communication; educational support plans at school are common, and behavioral therapies may help with attention, learning, or social skills. Medicines are used to treat features such as seizures, reflux, asthma, or attention difficulties when they occur, and regular check-ins track growth, development, hearing, vision, and any structural concerns like heart or kidney differences. Ask your doctor about the best starting point for you, and expect plans to be reviewed over time as needs change.
Non-drug treatment
Daily life with 11p15.4 microduplication syndrome often centers on supporting development, communication, feeding, and learning. Alongside medicines, non-drug therapies can build skills, prevent secondary problems, and ease day-to-day care. Early symptoms of 11p15.4 microduplication syndrome may include low muscle tone, speech delay, or feeding trouble, so starting support early can make a difference. Plans are tailored to each child and adjusted over time as needs change.
Coordinated services in infancy and toddler years help jump-start motor, speech, and social skills. Therapy intensity is matched to your child’s needs.
Guided movement exercises build strength, balance, and posture. This can reduce falls and help kids keep up with play and daily activities.
Fine-motor and self-care practice supports feeding, dressing, and handwriting. Therapists adapt tools and routines so tasks feel achievable.
Language, speech sounds, and social communication are strengthened through play-based practice. Some children use picture boards or devices while speech develops.
Your genes may have an impact on how drugs work for you
Medicines for 11p15.4 microduplication syndrome can work differently because extra copies of genes in that region may change how the body processes or responds to certain drugs. Clinicians often start low, adjust slowly, and consider pharmacogenetic testing to guide safer, more effective dosing.
Pharmacological treatments
Medicines for 11p15.4 microduplication syndrome focus on easing specific symptoms rather than changing the chromosome change itself. Not everyone responds to the same medication in the same way. When early symptoms of 11p15.4 microduplication syndrome include reflux, poor sleep, or seizures, doctors may try well-studied drugs used for those issues in children. Choices depend on age, severity, other health conditions, and how a child or adult tolerates a trial.
First-line options are stimulant medicines such as methylphenidate or amphetamine to improve focus and reduce hyperactivity. Non-stimulants like guanfacine or atomoxetine may help when stimulants aren’t tolerated or don’t cover symptoms well.
Levetiracetam is commonly used, with alternatives such as oxcarbazepine or valproate depending on seizure type. Doctors tailor the dose to balance seizure control with side effects.
Proton pump inhibitors such as omeprazole or lansoprazole reduce stomach acid and ease pain from reflux. H2 blockers like famotidine can be used for milder or intermittent symptoms.
Polyethylene glycol (PEG 3350) softens stools and makes bowel movements more comfortable. Lactulose is another gentle option if PEG does not work well enough.
Genetic influences
A small extra segment on chromosome 11 at region p15.4 means some genes are present in an extra copy, which can change how strongly they act. This gene “dosage” effect—like a dimmer switch turned up—can influence growth, learning, muscle tone, and other features seen in 11p15.4 microduplication syndrome. DNA testing can sometimes identify these changes. The duplication may arise for the first time in a child (de novo), or it can be inherited from a parent who also carries it, sometimes with very mild or no symptoms. When a parent has the same duplication, each pregnancy has about a 50% chance of inheriting it, but the way it shows up can vary widely from one person to another. Knowing the genetic cause can help explain early symptoms of 11p15.4 microduplication syndrome and guide family planning and care.
Is 11p15.4 microduplication syndrome genetic?
Genetics is central to 11p15.4 microduplication syndrome, which results from an extra copy of DNA in a specific region on chromosome 11. The exact duplicated genes and size influence symptoms and severity. Most cases are spontaneous, though inheritance can occur.
Pharmacogenetics—how genetics influence drug effects
Because 11p15.4 microduplication syndrome can affect several body systems, treatment often pairs therapies with medicines tailored to the symptoms present, such as seizures, attention differences, or anxiety. Genes can influence how quickly you break down certain medicines, which can change the dose that works best and the chance of side effects. This means two people on the same drug may need very different doses to get the same benefit.
The duplication itself usually doesn’t change the liver enzymes that process most drugs, so choices for medications used in 11p15.4 microduplication syndrome generally follow standard care, adjusted to the individual’s response and any other health conditions. Still, doctors keep features linked to the syndrome in mind—such as heart differences, low muscle tone, or feeding and growth issues—because these can affect how a drug is absorbed, how sleepy it makes someone, or how it interacts with other treatments. When medicine is needed, pharmacogenetic testing may help fine-tune dosing or suggest alternatives if side effects show up. Age, weight, other medicines, and diet also shape how someone responds.
Interactions with other conditions
In everyday life, feeding, breathing, and developmental challenges linked to 11p15.4 microduplication syndrome can intersect with other health issues, sometimes making days feel more complicated. Doctors call it a “comorbidity” when two conditions occur together. Low muscle tone and coordination delays can make reflux or swallowing problems worse, which may raise the risk of chest infections or make sleep apnea more likely. Neurodevelopmental conditions such as autism traits, attention difficulties, or anxiety can occur alongside the syndrome, and that overlap can blur whether a behavior change is due to learning needs, pain, poor sleep, or something else. If seizures, hearing or vision differences, or a heart issue are also present, they can add fatigue and affect growth and learning; medicines for one problem (for example, antiseizure drugs) may influence appetite, alertness, or therapy progress. For many families, early symptoms of 11p15.4 microduplication syndrome are harder to spot when reflux, recurrent ear infections, or sleep problems are also in the mix, so a shared plan across pediatrics, neurology, genetics, and therapy services can prevent one issue from amplifying another.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
History
Throughout history, people described babies and children who were smaller than expected, had feeding struggles, or learned skills later than their peers, without knowing a shared cause. Families and communities once noticed patterns that seemed to “run in the family,” but the details were hard to pin down. Doctors could only group these observations by outward features, which varied widely from one child to the next.
From early theories to modern research, the story of 11p15.4 microduplication syndrome follows advances in chromosome testing. In the late 20th century, standard karyotypes could spot large extra or missing pieces of chromosomes, but very small changes went unseen. As microarray technology and, later, high‑resolution sequencing became routine in genetics clinics, specialists began finding tiny, extra stretches of DNA on the short arm of chromosome 11, specifically the 11p15.4 region. Initially understood only through symptoms, later cases could be linked to these subtle gains of genetic material.
Once considered rare, now recognized as more common than early reports suggested, 11p15.4 microduplication syndrome emerged as labs compared results from many families worldwide. Some people with the microduplication had developmental delays or growth differences; others had only mild learning differences or no obvious symptoms, discovered incidentally during testing for another reason. This range made the history complicated: early publications likely captured only the more noticeable cases, while milder presentations were missed.
In recent decades, knowledge has built on a long tradition of observation. Clinicians documented detailed family histories, noting when the microduplication was inherited and when it appeared for the first time in a child. Researchers mapped the duplicated genes more precisely, helping explain why features could differ depending on the exact size and content of the duplicated segment. These historical steps shifted the focus from a single “typical” picture to an understanding that 11p15.4 microduplication syndrome spans a spectrum.
Knowing the condition’s history helps explain today’s approach: careful genetic testing paired with attention to each person’s strengths and needs. As laboratories refine testing and share anonymized data, the record continues to grow. Over time, descriptions became clearer, support options expanded, and families gained more accurate information about what to expect and how the microduplication can be passed on.