An external cause for 'idiopathic' pachymeningitis?

In a 67-year-old man with a history of professional asbestos exposure and persistent headaches since one year, a diagnosis of idiopathic pachymeningitis was made. IHCP (idiopathic hypertrophic cranial pachymeningitis) is in literature referred to as one of the presentations of Multifocal Idiopathic Fibrosclerosis or MIF, representing a group of fibro-inflammatory and pathologically similar diseases, including also retroperitoneal fibrosis, mediastinal fibrosis and sclerosing cholangitis. Since recent literature links asbestos exposure to a risk of development of retroperitoneal fibrosis, the present case suggests to focus in future research of IHCP on possible external causes.