Inclusion Criteria:  Adult (≥18 years) Acute pancreatitis as defined by a clinical diagnosis of pancreatitis and a lipase level ≥3x the upper limit of normal. Admission or planned admission to an intensive care unit SOFA disease severity score ≥3 (or at least 3 points above a known baseline)  Exclusion Criteria:  Known diagnosis of autoimmune pancreatitis Existing clinical indication for corticosteroids at a dose >5mg of oral prednisone daily (or equivalent) Contraindication to receiving corticosteroids Protected populations (prisoners) Pregnancy