According to the latest 2020 guidelines of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), children and adolescents can be diagnosed with coeliac disease without biopsy if they have IgA anti-transglutaminase antibodies (more sensitive) 10 times higher than normal or IgA anti-endomysial antibodies (more specific). It is not necessary to present symptoms or to request a genetic study (HLA DQ2/8) in this case. A negative serology with compatible symptoms does not exclude the diagnosis of coeliac disease. However, in the event of a positive serology, you should see your specialist doctor for a duodenal biopsy (or the accessory tests that your doctor deems appropriate) that will allow a definitive diagnosis to be made.